Utilization Management Specialist

Job Summary: We are seeking a detail-oriented and organized Clinical Coordination Specialist to join our team at MedPOINT Management. In this role, you will be responsible for coordinating clinical activities, communicating with healthcare providers, and maintaining accurate records of patient information.About the Role:The Clinical Coordination Specialist...

Job OverviewThe MedPOINT Management team is seeking an experienced Outpatient UM Clinician to join our team. This role is responsible for ensuring a thorough review of outpatient precertification/preauthorization referrals for members requiring outpatient services.In close collaboration with the Medical Director, the successful candidate will work towards...

Job Title: Nurse Utilization SpecialistJob SummaryWe are seeking a highly skilled and experienced Nurse Utilization Specialist to join our team at the West Los Angeles VA Medical Center. As a key member of our Outpatient Case Management department, you will play a crucial role in reviewing patient files and treatment methods to ensure efficient and effective...

Job Summary: We are seeking a highly skilled Medical Management Specialist to join our team at E-talentnetwork. This role is responsible for ensuring appropriate, cost-effective, and high-quality care for patients.About the Role:This position involves conducting utilization management activities in accordance with health plan policies and regulatory...

Job SummaryIn this challenging role, you will play a crucial part in ensuring our members receive the necessary healthcare services. As a Utilization Management Nurse Specialist RN II, you will facilitate and coordinate medically necessary referrals, ensuring timely and accurate determinations. You will also generate approval, modification, and denial...

Job Details:We are seeking a skilled Private Utility Specialist to join our team at USIC. As a key member of our crew, you will be responsible for providing utility locating services while building the business.Salary: $28-$30/hour + monthly bonusResponsibilities:Identify, locate, and mark all utilities within a requested job scopeManage sales cycle to close...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11724 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the...

Role Summary:We are seeking an experienced Registered Nurse (RN) to join our team as a Utilization Management Policy Initiatives Specialist. The successful candidate will have at least 8 years of previous experience in Clinical Nursing and a strong background in performing and creating clinical documentation.The ideal candidate will be responsible for...

About the RoleWe are seeking a seasoned Utility Coordinator to join our team at Dabri, Inc. as a Project Delivery Specialist. This role is a key position in supporting the Advanced Transportation Management Program (ATMP) for Transportation/Roadway projects at the Los Angeles World Airports (LAWA).The ideal candidate will possess extensive experience in...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse to join our team at Presidential Staffing Solutions, LLC. As a key member of our team, you will play a crucial role in reviewing patient files and treatment methods to ensure optimal efficiency and effectiveness.Your primary responsibility will be to monitor the activity of staff,...

At Essel, we are seeking a highly skilled and experienced Utilities Superintendent to join our team. This is an exciting opportunity for a motivated individual to take on a leadership role in managing utilities operations.

Job OverviewAt MedPOINT Management, we are seeking a highly organized and detail-oriented Procurement and Inventory Specialist to join our team. This role will be responsible for managing and coordinating purchases, vendor contracts, and inventory levels.The ideal candidate will have a strong analytical mindset and excellent communication skills. They will...

We are seeking a skilled Medical Case Manager to join our team at MedPOINT Management.As an Outpatient Utilization Specialist, you will play a crucial role in ensuring the quality and efficiency of our healthcare services.The estimated salary for this position is between $42,000 and $48,000 per year, depending on experience and qualifications.About the...

Key ResponsibilitiesWe are seeking a skilled Risk Management Specialist to join our team. In this role, you will be responsible for reviewing risk pool summaries, auditing risk pool detail, and submitting disputes to health plans or cap hospitals.

Job DescriptionWe are seeking a highly skilled Utilization Management Director to join our team at Kaiser Permanente.Job Summary:The ideal candidate will have extensive experience in directing utilization management and discharge planning in an acute care setting. This role is responsible for developing, managing, and directing the Utilization Management...

Job Summary: Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages programs that emphasize appropriate admissions as well as concurrent and retrospective review of care. May also be responsible for other integrated functions such as Discharge Planning, Case Management program, Outside...

We are seeking an experienced Clinical Operations Leader to join our team at Kaiser Permanente. This is a leadership role that requires strong management skills, knowledge of healthcare operations, and excellent communication skills.Job Summary:This position oversees the Utilization Management programs in a Service Area or Medical Center, ensuring compliance...

About the JobWe are looking for a talented Network Development Specialist to support our Contracts Team at MedPOINT Management. This is an excellent opportunity to apply your knowledge of healthcare contracting and network development.The ideal candidate will have experience in:Negotiating contracts with healthcare providersCoordinating with internal...

Established in 1957, Morrison Healthcare is a leading provider of food and nutrition services to more than 806 hospitals and healthcare systems across the United States.Morrison's mission is to create personalized dining experiences for patients and staff while advancing the healing and healthful missions of its clients. Our team of experienced chefs,...

Job OverviewThe Utilization Management Director balances individual patient and family needs with cost-effective utilization of resources. This role requires strong leadership skills and the ability to collaborate with an interdisciplinary team.Key Responsibilities:Assesses patients to determine the appropriateness of their level of care.Develops and...