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6,014,482 jobs across our US network. How we count
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Construction Materials Department Manager
Insight Global
…for developing and mentoring the team, managing staffing and utilization, overseeing project execution, budgets, forecasting, profitability, quality, and safety, and ensuring projects meet…
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Authorization Specialist II
Centene Corporation
…are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related…
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Senior Pharmacist - Strategy
Highmark Inc
Quality Assurance & Review: Serve as a peer-reviewer of medication reviews, pharmacy utilization management policies, and other strategy deliverables, as applicable.
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Registered Nurse - Remote $28.50/hr
TEKsystems
Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.
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Clinical Quality Reviewer (Coder/Auditor)
CorroHealth Inc
Ability to apply clinical judgment within regulated utilization management or prior authorization workflows.
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Licensed Physician Reviewer - Remote - Endocrinology
ChenMed, LLC
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising other physician reviewers and attending…
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Clinical Quality Assurance Coordinator (33133)
MES Solutions
Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
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RN Care Manager
Greater Baltimore Medical Center, Inc.
…care companies and other third party payers. Discusses on-site reviewer issues with payer, either via the telephone or in person. Assures timely utilization compliance with all payers who…
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RN Care Manager
Greater Baltimore Medical Center, Inc.
…care companies and other third party payers. Discusses on-site reviewer issues with payer, either via the telephone or in person. Assures timely utilization compliance with all payers who…
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Clinical Quality Assurance Coordinator (33133)
IME RESOURCES LLC
Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
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Unit Specialist III
ULSA University of Louisville
Generates ideas and solutions for the collaborative process to develop student engagement strategies for utilization and marketing of student well-being initiatives. With minimal…
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EAP Provider Network Recruiter
Acentra Health, LLC
…attracting physicians for flexible, as needed quality of care and utilization management review work. Responsibilities include warm and cold outreach, guiding prospective providers through…
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Remote Clinical Psychologist Utilization Reviewer (TX or MN Licensed) -1099 Contractor
MRIoA
…Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We’re a leader in Peer and Utilization Reviews, known for…
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Clinical Registry Reviewer
Children's Hospital Medical Center
…care. Review, analyze, and summarize recommendations regarding utilization, quality and severity measurements. Support quality improvement initiatives by providing data to physicians,…
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RN Senior Review Coordinator PT - Saturday's and Sunday's
Telligen
As a Senior Review Coordinator RN, you will be responsible for conducting utilization review/medical management for all services, including training/mentoring other team members, and…
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Manager, Support Operations
Syracuse University
Strong organizational, time management and communication (oral and written) skills required
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Group Health Oncology Utilization Review Nurse - Clinical Review Preparation
Dane Street, LLC
…as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due…
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Behavioral Health Nurse Navigator
The Health Plan of West Virginia Inc
Utilization Management, Case Management, Quality Improvement or other managed care experience with a payor organization.
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Claims Analyst
The Health Plan of West Virginia Inc
Under the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviewer must meet or exceed production and quality…
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RN, Registered Nurse Utilization Review
Quantum Health, Inc.
The Utilization Review Nurse is responsible for reviewing and processing medical services requests for members of Quantum Health’s employer groups in an inpatient setting and transitions in…
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GIS Analyst
Veolia North America
…leader. It offers a full spectrum of water, waste, and energy management services, including water and wastewater treatment, commercial and hazardous waste collection and disposal, energy…
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Utilization Management Representative I (US)
Elevance Health
The Utilization Management Representative I (US) will be responsible for coordinating cases for precertification and prior authorization review.
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Utilization Management Representative I (US)
Elevance Health
The Utilization Management Representative I (US) will be responsible for coordinating cases for precertification and prior authorization review.
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Utilization Management Representative I (US)
Elevance Health
The Utilization Management Representative I (US) will be responsible for coordinating cases for precertification and prior authorization review.
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Utilization Management Representative I (US)
Elevance Health
The Utilization Management Representative I (US) will be responsible for coordinating cases for precertification and prior authorization review.