Utilization Management Coordinator I Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination, and quality of care. Essential Functions: 35% Performs member or provider related administrative support which may
Utilization Review And Denials Management Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patients need for outpatient or inpatient care as well as
Utilization Management Nurse Specialist Company Description Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and
Utilization Management Coordinator Pay Range: $20.24hr - $24.24hr The Utilization Management Coordinator will provide administrative and operational support for utilization management activities, including authorization processing, benefit verification, claims inquiries, and coordination with members and providers. The role requires strong organizational skills, healthcare
Behavioral Health Analyst Pay Range: $46.76hr - $51.76hr Requirement/Must Have: Masters Degree or higher in Behavior Analysis, Psychology, Education, or a related field. Board Certified Behavior Analyst (BCBA) Required. Active state licensure as a Behavior Analyst
Utilization Review Specialist PURPOSE: Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist
Utilization Management Specialist (UM / Utilization Review Nurse) Remote In this role, youll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. Youll work fully remote and leverage MCG,
Utilization Management Nurse (RN) - Part Time Part Time - Day shift (8a-4:30pm), HYBRID role (Work both in Annapolis & at home) weekend/holiday rotation. Will work 56 hours every 2 weeks. FLSA status: Hourly/Non-Exempt. Will have access to
Spec, Utilization Management Job Location: Baltimore, MD Job Description: Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking
Health Services - Spec, Utilization Management Location: Baltimore, MD Utilizing key principles of utilization management, the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical
Business Integration Lead Were seeking a Business Integration Lead with strong healthcare integration experience to drive complex, cross-functional initiatives. This role leads program execution, aligns stakeholders, and ensures measurable improvements in PA performance, provider experience, and
Summary All Native Group is seeking a Management and Program Analyst II position to provide skilled — and largely independent — administrative analytical and evaluative work to program operations and, management and organizational efficiency and productivity for the
Job Seekers can review the Job Applicant Privacy Policy by clicking here. Job Description: Summary The Operations Management Trainee will support the shop management process and assist in cost savings, customer retention, and metric-based initiatives. This requires the
The Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health is seeking a Research Assistant to support the Johns Hopkins Drug Access and Affordability Initiative, which develops policy-relevant research and bipartisan
We are the leading provider of professional services to the middle market globally, our purpose is to instill confidence in a world of change, empowering our clients and people to realize their full potential. Our exceptional
Job Seekers can review the Job Applicant Privacy Policy by clicking here. Job Description: Summary The Operations Management Trainee will support the shop management process and assist in cost savings, customer retention, and metric-based initiatives. This requires the
JOB SUMMARY: The Director is responsible for the complete oversight and accountability of all deliverables associated with the growth of the RFP Response program, as well as Rate Enablement and Visibility, specifically targeting corporate transient accounts.
Overview Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of the Johns Hopkins locations. Our employees are the strength of our
Job Seekers can review the Job Applicant Privacy Policy by clicking here. Job Description: Summary The Operations Management Trainee will support the shop management process and assist in cost savings, customer retention, and metric-based initiatives. This requires the
Location: Washington, DC (NOVA), DC, United States Job ID: 89429 We Elevate. Quality of urban life Our elevators, escalators, and moving walks safely transport more than two billion of us up and down buildings and across