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Utilization Management Nurse, Senior
LONG BEACH, CALIFORNIA, UNITED STATES
Your RoleThe Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events. The Utilization Management Nurse, Senior will report to the Senior Manager, Facility...
Utilization Management Nurse, Senior (Prior Auth)
RANCHO CORDOVA, CALIFORNIA, UNITED STATES
...and medical policy compliance. Clinical judgment and detailed knowledge of benefit plans used to complete review decisions is required . Your WorkIn this role, you will: Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for...
Utilization Management Nurse, Senior
RANCHO CORDOVA, CALIFORNIA, UNITED STATES
...medical policy compliance and contract compliance Ensure discharge (DC) planning at levels of care appropriate for the members needs and acuity and determine post-acute needs of member including levels of care, durable medical equipment, and post service needs to ensure quality and...
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Utilization Management Nurse, Senior (Prior Authorization - CalPERS)
RANCHO CORDOVA, CALIFORNIA, UNITED STATES
...medical policy compliance and contract compliance Provides SME and support to team members Conduct UM review activities for appropriate member treatment to meet appropriateness of care based on medical necessity criteria Triages and prioritizes cases to meet required turn-around times...
Clinical Value Analysis Director
THOUSAND OAKS, CALIFORNIA, UNITED STATES
...organization s contract portfolio; and developing and executing product standardization with the value analysis committees. The Clinical Resource Director has a broad enterprise and segment influence and will need to build strategic alliances with Hospital Leadership, Physicians and...
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Clinical Resource Director - Healthcare
THOUSAND OAKS, CALIFORNIA, UNITED STATES
...organization s contract portfolio; and developing and executing product standardization with the value analysis committees. The Clinical Resource Director has a broad enterprise and segment influence and will need to build strategic alliances with Hospital Leadership, Physicians and...
Clinical Resource Director
THOUSAND OAKS, CALIFORNIA, UNITED STATES
...organization s contract portfolio; and developing and executing product standardization with the value analysis committees. The Clinical Resource Director has a broad enterprise and segment influence and will need to build strategic alliances with Hospital Leadership, Physicians and...
We've expanded the search to "United States of America" to find more jobs with all your keywords
Contract Manager
HERSHEY, PENNSYLVANIA, UNITED STATES
...MHS is seeking a Contract Manager for its Procurement team. This is an onsite, year-round position that compensates between 85,000 - 90,000 annually (pay is determined based on experience) and includes an excellent benefits package. The Procurement Contract Manager (PCM) provides...
International Trade Compliance Program Manager
WASHINGTON, DISTRICT OF COLUMBIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
GAITHERSBURG, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
BROOKLYN, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
SPARROWS POINT, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
WASHINGTON, DISTRICT OF COLUMBIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
ELLICOTT CITY, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
WASHINGTON, DISTRICT OF COLUMBIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
WASHINGTON, DISTRICT OF COLUMBIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
VIENNA, VIRGINIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
BALTIMORE, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
BOWIE, MARYLAND, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
International Trade Compliance Program Manager
WASHINGTON, DISTRICT OF COLUMBIA, UNITED STATES
Description Would you like to use your trade licensing and compliance expertise to help create the next defining innovation? Do you like to work on novel legal issues that enable next-generation technological innovation? If so, we're looking for someone like you to join our team at APL. Join...
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