21 utilization management services rep i jobs found

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under general supervision, manages and coordinates the technical activities of section imaging staff engaged in producing ionizing and nonionizing radiation images for use in the diagnoses of disease or physical disorders. Oversees, assists and instructs Radiology technologists and ancillary personnel in the performance of their daily duties as established by departmental policy and procedures. Flexibility to work overtime as needed. Call is mandatory. Job Description: Essential Duties & Responsibilities including but not limited to: 1) Manages and coordinates the technical activities of section imaging staff. a) Plans and schedules work for assigned area ensuring proper distribution of assignments and adequate staffing coverage, space and facilities for performance of duties of technologists. b) Supervises and provides instruction ot technologists and...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The RN House Supervisor is a registered professional nurse who provides hospital wide leadership to all departments and divisions through the effective use of advance competencies in communication, job knowledge, professionalism and business skills to promote the creation of a center of excellence for staff recruitment and retention, and in clinical and business outcomes. This leader is a member of the leadership team and is responsible for...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

Job Description Summary This positions includes a $10,000 sign on bonus and up to $5,000 in relocation assistance. Provides timely and quality clinical information by performing diagnostic imaging procedures, monitoring, and evaluating departmental processes and healthcare provider utilization to ensure appropriate utilization of diagnostic imaging services and improved patient outcomes. Performs duties associated with technical practice, personnel management, fiscal management, and professional development. Proactively supports efforts to ensure delivery of safe patient care and services. Promotes a safe environment at MUSC Children’s Health. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC000651 CHS - Radiology - Clinical Support Services (Main) Pay Rate Type Hourly Pay Grade Health-29 Scheduled Weekly Hours 40 Work Shift Job Description Demonstrates proficiency in the use...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

Job Description The Credit Analyst I will be responsible for evaluating customer creditworthiness, analyzing financial data, and supporting risk management decisions to minimize company exposure while maintaining strong customer relationships. This role reviews credit applications, monitors existing accounts, manages customer account setups and maintenance, and recommends credit limits to support timely and accurate credit decisions. Serves as a critical liaison between Sales, Finance, and external credit bureaus by utilizing platforms like HighRadius, Salesforce and Nabors myRequest to ensure policy compliance and drive business growth. Resolves moderately complex credit issues independently, collaborates with Manager on highly sensitive accounts, and assists with other duties related to Credit & Corporate Card Department functions. All duties are performed in full compliance and accordance with corporate policies, internal controls, and external regulatory reporting...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services. Location: Duke Regional Hospital Work Week: PRN as needed General Description of the Job Class Coordinate and participate in a variety of technical tasks, tests and determinations involving the utilization of radioactive materials and measurement instrumentation. Duties and Responsibilities of this Level Coordinate and participate in a variety of technical...

Katie Miller Special Education Teacher Help Others, Make a Difference, Save a Life. Do you want to make a difference in people's lives every day? Or help people navigate the tough spots in their life? And do it all while working where your hard work is appreciated? You have a lot of choices in where you work…make the decision to work where you are valued! Join the McNabb Center Team as the Katie Miller Special Education Teacher today! The Katie Miller Special Education Teacher Summary of position : The position will be responsible for the individual educational needs of the clients at Katie Miller & Gateway Academy including the special needs of students identified with Special Education certification and students with 504 plans. The Teacher will develop lesson plans, delegate tasks to the assistants, report progress to the Program Coordinator. This position will participate in treatment planning for the residents and utilize the behavioral system...

Mill Valley, California, United States Position Title: Delivery Excellence & Agile Transformation Leader About the Position Were seeking a Delivery Excellence & Agile Transformation Leader to strengthen delivery governance across our national digital transformation and PMIS advisory practice, serving mega capital infrastructure construction programs across aviation, ports, rail/transit, transportation, utilities, energy, water, or public works sectors. Youll set the cadence and quality standards that keep large, multi-stakeholder programs on track, translate client priorities into structured delivery plans, escalate risk early, and build the playbooks that let our delivery teams scale. This is a long-term, full-time, hybrid position located in Phoenix, AZ, and will require approximately 10% travel monthly. Responsibilities may include, but are not limited to, the following: Establish and maintain delivery cadence across client engagements,...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

Nemours is seeking a Quality & Data Coordinator (HemOnc), Full-Time, to join our Hematology Oncology team in Orlando, Florida. This position is responsible for management and oversight of quality projects and data critical to advancement of quality and service for the Lisa Dean Moseley Foundation Institute for Cancer and Blood Disorders (LDMFI-CBD). Provides data assembly and appropriate management of respective databases. Synthesizes and interprets clinical data and identifies appropriate action items to improve clinical outcomes. Develop, implement, manage, and evaluate data requirements for the Lisa Dean Moseley Foundation Institute for Cancer and Blood Disorders accreditation programs, including but not limited to the Foundation for the Accreditation of Cellular Therapy (FACT) and the American College of Surgeons (ACOS) Commission on Cancer (COC), transplant and cellular therapy products (e.g., Chimeric Antigen Receptor T-Cell (CAR-T) and gene therapy. Develops improved...

Job Description: Summary: This position supports the workflow of the Long-Term Support and Services (LTSS) and Duals Special Needs (DSNP) department. Depending on the specific tasks assigned, the LTSS/DUALs SN Project Coordinator provides administrative support for DUALs and/or LTSS staff. This position acts as an administrative support resource for staff regarding members' specific contract benefits; consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral process, as well as functions related to legislative and federal regulatory mandates related to the Health Plan. The position also supports member centric care within LTSS/DUALs programs Essential Accountabilities: Level I: Review / prep clinical case for clinical staff. Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to the division. Serves as the primary...

Job Description: Summary: This position supports the workflow of the Long-Term Support and Services (LTSS) and Duals Special Needs (DSNP) department. Depending on the specific tasks assigned, the LTSS/DUALs SN Project Coordinator provides administrative support for DUALs and/or LTSS staff. This position acts as an administrative support resource for staff regarding members' specific contract benefits; consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral process, as well as functions related to legislative and federal regulatory mandates related to the Health Plan. The position also supports member centric care within LTSS/DUALs programs Essential Accountabilities: Level I: Review / prep clinical case for clinical staff. Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to the division. Serves as the primary...

Job Description: Summary: This position supports the workflow of the Long-Term Support and Services (LTSS) and Duals Special Needs (DSNP) department. Depending on the specific tasks assigned, the LTSS/DUALs SN Project Coordinator provides administrative support for DUALs and/or LTSS staff. This position acts as an administrative support resource for staff regarding members' specific contract benefits; consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral process, as well as functions related to legislative and federal regulatory mandates related to the Health Plan. The position also supports member centric care within LTSS/DUALs programs Essential Accountabilities: Level I: Review / prep clinical case for clinical staff. Navigates and utilizes corporate applications; core claims and membership system, intranet and related links to provide support to the division. Serves as the primary...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Potential for...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Potential for...

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Potential for...