Utilization Management Jobs NY
for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is
Created: 2024-06-25
range of medical/clinical knowledge. + Expertise in, or willing to learn utilization management , state/federal regulations, private payer contracts. + ...
Created: 2024-06-20
findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and
Created: 2024-06-12
team clinical and nonclinical team activities to facilitate integrated proactive utilization management . Performs Case Management functions through
Created: 2024-06-11
works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to
Created: 2024-06-08
resolving complex problems that include but are not limited to pre-certifications; Utilization Management ; coordination of benefits; baby not on policy; ...
Created: 2024-06-03
experience, required. + Minimum of seven (7) years administrative experience in Quality Management Utilization Management . + 7+ years of Quality
Created: 2024-06-01
/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical,
Created: 2024-05-30
while maintaining the quality of care. The Care Manager actively participates in the utilization management process using standards of care to determine ...
Created: 2024-05-23
an important role in ensuring physician support and execution of for Utilization Management and Documentation strategies and processes. Responsibilities: +
Created: 2024-04-20
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