Utilization Manager Jobs in Orange
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Search Results - Utilization Manager Jobs in Orange
Equiliem-Orange
from behavioral health providers. They are also responsible for utilization management, quality reviews and monitoring activities of BHT services. The Care Manager will directly interact with providers for care coordination for BHT/ABA services.
Duties...
resume-library.com -
Orange
will respond to verbal and written grievances and appeals from members and providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions and pharmacy and vision decisions.
The incumbent...
governmentjobs.com -
Equiliem-Orange
medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director’s decision and documents follow-ups in the utilization management system.
Completes required documentation for data entry...
resume-library.com -
Orange
CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (LVN) to join our team. The Quality Improvement (QI) Nurse Specialist (LVN) for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's...
governmentjobs.com -
Impresiv Health-Orange
behavioral health providers. The incumbent is responsible for utilization management, quality reviews and monitoring activities of BHT services. The incumbent will directly interact with providers for care coordination for BHT/ABA services.
What You Will Do...
resume-library.com -
Impresiv Health-Orange
goals/priorities for the department.
Analyzes requests with the objective of monitoring utilization of services, this includes medical appropriateness and identifying potential high cost, complex cases for outpatient case management intervention...
resume-library.com -
JobTracks, Inc.-Orange
and outpatient utilization management systems focused on behavioral health and Substance Use Disorders
Develop, operationalize and manage inpatient and outpatient case management systems focused on behavioral health and Substance Use Disorders
Develop...
resume-library.com -
Impresiv Health-Orange
billing and coding
Certified Medical Assistant (CMA) certification, preferred
Previous experience with concurrent review and utilization management
Knowledge of Medi-Cal and Medicare benefits and regulations
Bilingual in English and one...
resume-library.com -
Impresiv Health-Orange
spreadsheets and/or other information applicable to the position assignment.
You have knowledge of:
Guidelines and regulations relevant to case management and utilization management.
Confidentiality and the legal and ethical issues pertaining to case...
resume-library.com -
US Tech Solutions, Inc.-Orange
Certified medical assistant (CMA) certification.
Concurrent review and utilization management experience.
Bilingual in English and in one of Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).
Knowledge & Abilities...
resume-library.com -
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