Utilization Review Jobs in USA

OverviewThe Quality Management Coordinator is an in-office position responsible for assisting with the preparation of dental records (charts and x-rays) opening new grievances and managing payer and dental board complaints. This position ensures all grievances and appeals are processed in a timely m...

OverviewThe Quality Management Coordinator is an in-office position responsible for assisting with the preparation of dental records (charts and x-rays) opening new grievances and managing payer and dental board complaints. This position ensures all grievances and appeals are processed in a timely m...

Location:Geisinger Centralized Logistics & Materials Distribution Center (CLAM)Shift:Days (United States of America)Scheduled Weekly Hours:40Worker Type:RegularExemption Status:YesJob Summary:Functions as a pharmacist at the Retail Site Pharmacy and provides efficient accurate and safe medication se...

At Elara Caring we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals providing the Right Care at the Right Tim...

DescriptionAs part the Mount Sinai Pharmacy team and on behalf of Mount Sinai Human Resources partners the Pharmacy Benefits Program Director is responsible to provide service support reporting pricing and/or other performance guarantees while working with multiple internal stakeholders and other ex...

DescriptionAs part the Mount Sinai Pharmacy team and on behalf of Mount Sinai Human Resources partners the Pharmacy Benefits Program Director is responsible to provide service support reporting pricing and/or other performance guarantees while working with multiple internal stakeholders and other ex...

ABOUT MARINHEALTHAre you looking for a place where you are empowered to bring innovation to reality Join MarinHealth an integrated independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team an affiliation with UCSF Health an ever-expanding...

POSITION SUMMARY:The Associate Authorization is a position responsible for ensuring that patient care services are ready to bill accurately and in a timely manner. The primary responsibility of the role is to obtain authorization for care from insurance carriers and provide denial support. This posi...

Department:11200 Navicent Health Medical Center - Case ManagementStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:M-F 8am til 5pm w/ variable holidays/ weekend rotationsPay Range$41.10 - $61.65Major ResponsibilitiesParticipates in rounds on the patient c...

Retail Pharmacy Tech need to 40 hours per week in Beautiful Salida and Westcliffe of the Rockies Regional Medical Center is an officially accredited Critical Access Hospital by The Joint technician needs experience ensuring that all regulatory requirements of each prescription are met before proce...

Retail Pharmacy Tech need to 40 hours per week in Beautiful Salida and Westcliffe CO. Heart of the Rockies Regional Medical Center is an officially accredited Critical Access Hospital by The Joint Commission. The technician needs experience ensuring that all regulatory requirements of each prescript...

Retail Pharmacy Tech need to 40 hours per week in Beautiful Salida and Westcliffe CO. The technician needs experience ensuring that all regulatory requirements of each prescription are met before processing the order. Prior retail or outpatient pharmacy technician experience is required. Shift: M-F...

**REDUCED Non-Billable Orientation (NBO) Job - 0 Hours NBO vs. Standard 40 NBO** OR WA or CA Pharmacist License Required 3 Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations Audits Appeals ALJ Court hearings etc) **Rare weekends required a few times per year** RE...

Registered Nurse Case ManagerProfession: Registered Nurse Specialty: Case ManagementAssignment DetailsShift: Day Shift 5x8 HoursSchedule: 8:00 AM 4:30 PMContract Length: 13 WeeksLocation: Santa Rosa CaliforniaPosition OverviewWe are seeking an experienced Registered Nurse Case Manager for a healt...

Registered Nurse Case ManagerProfession: Registered Nurse Specialty: Case ManagementAssignment DetailsShift: Day Shift 5x8 HoursSchedule: 8:00 AM 4:30 PMContract Length: 13 WeeksLocation: Eureka CaliforniaPosition OverviewWe are seeking an experienced Registered Nurse Case Manager for an acute ca...

GRADE 22 LOCATION OF POSITION MDH Office of Pharmacy Services Clinical Services Division Baltimore MD Main Purpose of Job This position will supervise and direct all clinical pharmacy services for the Clinical Services Division provided to Office ofPharmacy Services (OPS) participants t...

Provides utilization management functions as a part of the Program for All Inclusive Care for the Elderly benefits management system. This includes providing utilization review and management for all acute post-acute and outpatient services as well as performing the identification analysis and resol...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your care...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your care...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your care...