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UTILIZATION MANAGEMENT REPRESENTATIVE II

Job Family: Customer Care Type: Full time. Date Posted: Mar 08, 2024 Anticipated End Date: Apr 26, 2024 Reference: JR108675. Responsible for providing technical guidance to UM Reps who handle correspondence. Assist callers with is...

CompanyElevance Health
AddressManchester, NH
CategoryRetail
Salary$15.56 - $24.58 an hour
Job typeFull-time
Date Posted 2 months ago See detail

Utilization Management Representative II

Elevance Health

Manchester, NH

$15.56 - $24.58 an hour

Job Family: Customer Care Type: Full time. Date Posted: Mar 08, 2024 Anticipated End Date: Apr 26, 2024 Reference: JR108675. Responsible for providing technical guidance to UM Reps who handle correspondence. Assist callers with is...

2 months ago seen See more...

Utilization Management Coordinator

Astrana Health

Monterey Park, CA

Comply with UM policies and procedures. Annual review of selected UM policies. Read and understand NMM UM Customer Service Policy and Procedures. Answer incoming calls from providers both contracted and non-contracted. (Average 60...

2 months ago seen See more...

Remote Utilization Management (UM) Coordinator (Long-Term Temporary w/ Medical Benefits)

Alignment Healthcare

Lake Forest, CA

Pacific Time: 8am - 5pm. Mountain Time: 9am - 6pm. Central Time: 10am - 7pm. Eastern Time: 11am - 8pm. Monitor fax folders. Verify eligibility and / or benefit coverage for requested services. Enter pre-service requests / authoriz...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Charleston, WV

$26.01 - $56.13 an hour

Must have active, current and unrestricted RN licensure in state of residence. 3+ years of clinical experience. Position requires proficiency with computer skills which includes navigating multiple systems. Ability to work in a fa...

2 months ago seen See more...

ISNP Utilization Management Nurse

Longevity Health Plan

United States

$79,000 - $96,000 a year

Receives requests for authorization of services, including inpatient hospital admissions, outpatient and/or inpatient elective surgery, and referrals for specialty physician consultation with non participating physician offices....

2 months ago seen See more...

CarePlus - Weekend Utilization Management Nurse, RN - Remote- Florida

Humana

Lorida, FL

Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to re...

2 months ago seen See more...

Utilization Management LPN

Allegiance Benefit Plan Mgmt.

Remote

$24.75 an hour

Able to initiate phone calls requesting information for admissions and continued stay reviews. Evaluates and authorizes the medical necessity of Services requested. utilizing, but not limited to the below criteria:. American Socie...

2 months ago seen See more...

Utilization Management Denial Review Nurse - LVN

Ucla Health

Los Angeles, CA

$61,400 - $121,400 a year

DescriptionQualificationsWere seeking an exceptionally gifted, self-motivated leader with: * Current CA LVN licensure required * Two or more years of utilization review/Utilization Management experience in an HMO, MSO, IPA, or he...

2 months ago seen See more...

Utilization Management Supervisor (Dental Insurance)

Liberty Dental Plan

Tustin, CA

$58,760 - $76,388 a year

Assist with recruiting, hiring, evaluation, and selection. Update job descriptions and develop performance expectations. Supervise employee and team performance. Train and provide adequate coaching, counseling, and motivation; ide...

2 months ago seen See more...

Utilization Management Medical Director - WellMed Medical Group

Optum

San Antonio, TX

$122K - $154K a year

Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values. Educates primary care physicians regarding systems, structures, processes and outcom...

2 months ago seen See more...

Utilization Management Nurse Consultant Afternoon Shift

Cvs Health

Columbus, OH

$29.10 - $62.31 an hour

Weekend/holiday coverage will occasionally be required. This candidate will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Utilizes clinical experience an...

2 months ago seen See more...

Utilization Management Coordinator

Rochester Regional Health

Rochester, NY

$21.50 - $31.60 an hour

Pension Plan Retirement Plan Comprehensive Benefits Package Tuition Reimbursement Benefits Effective Date of Hire Same Day Pay through Daily Pay 3 years of Utilization Management experience preferred 3 years of acute hospital care...

2 months ago seen See more...

Case Manager Utilization RN, 32/hr Day

Kaiser Permanente

Los Angeles, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

4 weeks ago seen See more...

Case Management Utilization RN, 20/hr Day

Kaiser Permanente

San Diego, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

4 weeks ago seen See more...

Case Manager Utilization RN-Per Diem

Kaiser Permanente

Ventura, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

a month ago seen See more...

Case Management Utilization RN PD Day

Kaiser Permanente

Harbor City, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

a month ago seen See more...

Nurse Case Manager/Utilization Review Nurse I

State Of Vermont

Burlington, VT

80% State paid medical premium and a dental plan at no cost for employees and their families. Work/Life balance: 11 paid holidays each year and a generous leave plan. State Paid Family and Medical Leave Insurance (FMLI). Two ways...

a month ago seen See more...

Case Manager Utilization RN, 32/hr Day

Kaiser Permanente

Panorama City, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

a month ago seen See more...

Manager of Utilization Management (Remote U.S.)

Acentra Health

Remote

$73.7K - $93.3K a year

Oversee, coordinate, and monitor all Clinical team activities related to programs assigned. Ensure adequate staffing, contractual service levels, URAC requirements, and regulatory requirements are adhered to by implementing and mo...

a month ago seen See more...

Resource Utilization/Classification Tech - HIM Reimbursement Specialist - PT - Remote

Mercyone

Dubuque, IA

$47.6K - $60.3K a year

Wellness programs Education reimbursement Personalized health insurance plans including dental and vision Paid time off Long- and short-term leave Retirement planning Life insurance coverage Demonstrates specific customer focused...

a month ago seen See more...

Utilization Review-Case Management (Full-Time)

Aurora San Diego

San Diego, CA

$66,560 - $124,800 a year

Pay Range: $32/hr. to $60/hr. Admissions: Conduct admission reviews. Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews. Payment Appeals: Prepare and submit appeals to third party payers. Recordkeeping: Maintain...

a month ago seen See more...

Solutions Management Director - Utilization Management

Elevance Health

NORFOLK, VA

Provides consultation and advice to business partners regarding benefits of products and analytics. Explains timelines and measures of success for implementing these products. Coordinates with the Physician Liaison regarding clini...

a month ago seen See more...

Case Manager Utilization RN, 24/hr Mid-Shift

Kaiser Permanente

Los Angeles, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

a month ago seen See more...

Utilization Review Specialist

Ambrosia Treatment Centers

Lorida, FL

From $69,900 a year

401(k). Dental insurance. Disability insurance. Health insurance. Life insurance. Paid time off. Vision insurance. 8 hour shift. Monday to Friday. Bachelor's (Preferred). Utilization review: 2 years (Required). Florida (Required)....

a month ago seen See more...

Manager - Case Management & Utilization Review, Jay Hospital

Baptist Health Care Corporation

Jay, FL

3 years nursing experience in the clinical setting Required. 1 year Case Management or Utilization Review experience Preferred. Excellent verbal and written communication skills required. Understands health care finance relative t...

a month ago seen See more...

Case Manager Utilization RN-Per Diem Day

Kaiser Permanente

Los Angeles, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

a month ago seen See more...

RN SPECIALIST RN UTILIZATION

Honorhealth

Scottsdale, AZ

Reviews clinical documentation and facilitates modifications (as needed) to ensure that documentation accurately reflects the level of service rendered and severity of illness (in compliance with government and other regulations)...

2 months ago seen See more...

Utilization Review Specialist

Charlie Health

Remote

$61K - $77.2K a year

Oversees all functions of a virtual IOP caseload. Completes peer reviews on cases with insurance. Collaborates at a high level to problem solve on complex cases with Manager. Completes pre-certs and continued stay authorizations f...

2 months ago seen See more...

Staff Development Specialist in Utilization Review

Reportprep, Inc

Palestine, TX

$45,000 - $75,000 a year

401(k) matching. Dental insurance. Disability insurance. Employee assistance program. Flexible spending account. Health insurance. Health savings account. Life insurance. Paid sick time. Paid time off. Vision insurance. Monday to...

2 months ago seen See more...

Utilization Review Case Manager CMC

Utmb Health

Friendswood, TX

Demonstrates thorough knowledge of Inter Qual Criteria, CMC Specialty Referral Guidelines and Protocols used to determine status for inpatient admission or observation in Community Hospitals and UTMB-TDCJ Hospital. Performs utiliz...

2 months ago seen See more...

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