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Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
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Job Description Position Summary EMPLOYER PAID PENSION PLAN OF 29.75% OF YOUR ANNUAL SALARY! GENEROUS BENEFITS PACKAGE! **OPEN TO CURRENT UMC EMPLOYEES ONLY** This position is considered AT-WILL and will serve ..
Job Information Humana UM Medical Director - Conviva in Las Vegas Nevada Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana Senior Project Manager -- Remote in Las Vegas ... Vegas Nevada Description The Senior Project Manager manages all aspects of a ... manages all aspects of a..
PURPOSE AND SCOPE:The student intern supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. The student ..
... provider experience, as well as project manage the market rollout end-to-end. ... Medicaid markets Create and manage project plans to ensure effective and ... and timelines for provider services..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
