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CVS Health
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Columbus, Ohio
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promote quality effectiveness of Healthcare Services and benefit utilization
Consults and lends ...
Experience in healthcare utilization management, critical care, emergency department, or case management
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CVS Health
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Columbus, Ohio
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Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization ... .
Position Summary
_Utilization Management is a 24/7 operation and work schedules may include
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Acadia Healthcare
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Columbus, Ohio
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' experience with the population of the facility and previous experience in utilization management required ... Description
The Utilization Review Specialist is an essential role at Mount Carmel
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Humana
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Columbus, Ohio
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**
Experience with Pharmacy Benefit Manager, Pharmacy, or Healthcare data, in particular drug utilization ... company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for
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Dulla Care Home Healthcare
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Columbus, Ohio
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Dulla Care Home Healthcare LLC
Home Health Specialist II
Reports to: Clinical Director/RN or Operations Director
Dulla Care Home Healthcare is creating the most advanced and complete in-home care model
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McKesson Corporation
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Columbus, Ohio
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible
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McKesson Corporation
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Columbus, Ohio
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible
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Humana
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Columbus, Ohio
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medical interpretation and determinations whether services provided by other healthcare professionals are ... in teams focusing on quality management, utilization management, case management, discharge planning
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McKesson Corporation
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Columbus, Ohio
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible
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Humana
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Columbus, Ohio
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communication of medical services and/or benefit administration determinations. The Utilization Management Nurse ... !** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent
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CVS Health
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Columbus, Ohio
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plans to promote effective utilization of health services service. Promotes/supports quality effectiveness of Healthcare Services.
Position Responsibilities:
Responsible for initial
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Trinity Health
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Columbus, Ohio
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. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of ... , appropriate utilization of resources and patient advocacy.
Responsibilities
Identifies
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Humana
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Columbus, Ohio
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, other healthcare providers, clinical group practice management.
Utilization management experience ... medical interpretation and determinations whether services provided by other healthcare professionals are
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Highmark Health
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Columbus, Ohio
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captures all inbound phone inquires for utilization management review from providers and pharmacies. The ... Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc
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Humana
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Columbus, Ohio
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insurance, other healthcare providers, clinical group practice management.
Utilization management ... interpretation and determinations whether services provided by other healthcare professionals are in agreement
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Elevance Health
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Columbus, Ohio
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clinical pharmacy services, including extensive experience in specialty pharmacy management preferred ... drug utilization, improve patient health outcomes, and control costs for chronic health conditions
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Humana
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Columbus, Ohio
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determinations whether services provided by other healthcare professionals are concordant with national ... , with prior experience participating in teams focusing on quality management, utilization management
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CVS Health
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Columbus, Ohio
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/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of ... **
Crisis Intervention skills preferred.
Managed care/utilization management experience preferred. Case
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CVS Health
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Columbus, Ohio
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/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of ... **
Crisis Intervention skills preferred.
Managed care/utilization management experience preferred. Case
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CVS Health
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Columbus, Ohio
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utilization management, quality management, network management and clinical coverage and policies ... .
Coordinates with the MCOs' care management staff and providers on medical services not included in the aligned
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TEKsystems
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Columbus, Ohio
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access hospitals.
-Proficiency in the utilization of project management scheduling tools (e.g. MS ... initiation, planning, execution and closure phases of the project life cycle for healthcare IT projects
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Humana
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Columbus, Ohio
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insurance, other healthcare providers, clinical group practice management
Utilization management ... focusing on quality management, utilization management, case management, discharge planning and/or home
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Highmark Health
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Columbus, Ohio
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then creates the case (data entry) in Highmark's utilization management system for clinical review ... utilization management system.
Use knowledge of process and judgement to evaluate identified cases that
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Humana
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Columbus, Ohio
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interpretation skills, with prior experience participating in teams focusing on quality management, utilization ... , hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers
Utilization
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Highmark Health
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Columbus, Ohio
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, and then creates the case (data entry) in Highmark's utilization management system for clinical review ... utilization management system.
Use knowledge of process and judgement to evaluate identified cases that
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Humana
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Columbus, Ohio
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of services provided by other healthcare professionals in compliance with review policies, procedures ... improving consumer experiences
Preferred Qualifications
Medical utilization management
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Sutherland Global Services
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Columbus, Ohio
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Utilization Management Appeals
Prior Authorization Verification
Eligibility and Benefits
Status ... industries from financial services to healthcare, entertainment to retail, insurance to gaming, and
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The Hartford
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Columbus, Ohio
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Dir Data Architecture - GT06AE
We’re determined to make a difference and are proud to be ... the future.
T he Hartford's Enterprise Data Services (EDS
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Humana
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Columbus, Ohio
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clinical services
Experience in utilization management review and case management in a health plan ... Humana insurance services and CenterWell healthcare services, we make it easier for the millions of
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McKesson Corporation
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Columbus, Ohio
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible
...
