Jobs: Milliman

** Third Party Application Support Specialist - IntelliScript** **Job Category****:** Information Technology **Requisition Number****:** THIRD005389 Showing 1 location **Job Details** **Description** Milliman IntelliScript is a specialty software-as-a-service (SaaS) unit of Milliman that pioneers industry-advancing risk management insurtech. IntelliScript...

In this role, the successful candidate Coordinates, negotiates, procures, and manages the care of patients by providing focused care coordination across the acute care continuum.Communicates the outcome of chart review and managed care company telephonic review with the health care team as appropriate.Conducts accurate reviews using CMS, Milliman Care...

In this role, the successful candidate Coordinates, negotiates, procures, and manages the care of patients by providing focused care coordination across the acute care continuum.Communicates the outcome of chart review and managed care company telephonic review with the health care team as appropriate.Conducts accurate reviews using CMS, Milliman Care...

Description:RESPONSIBLE FOR: The Care Manager is responsible for care coordination, progression of care, and proactive discharge planning and is accountable for expediting the timely and safe discharge for all patients in their case load. Qualifications:MINIMUM EDUCATION REQUIRED:Graduate of Nursing ProgramMINIMUM EXPERIENCE REQUIRED:Two (2) years of...

Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all denials by conducting a comprehensive...

Utilization Management Coordinator (RN)Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all...

Utilization Management Coordinator (RN)Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all...

Utilization Management Coordinator (RN)Under the general supervision of the Director of Health Services, the position is responsible for appropriately and successfully executing clinical and administrative health plan denials in accordance with regulatory guidelines and plan policies. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Is responsible for managing all...

Overview: As a Utilization Review Nurse, you will work under the direct supervision of the Supervisor, Utilization Review and Clinical Documentation Improvement, this role will be responsible for providing clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services....

Description:RN Care Manager - Full-time days RESPONSIBLE FOR: The Care Manager is responsible for care coordination, progression of care, and proactive discharge planning and is accountable for expediting the timely and safe discharge for all patients in their case load.Qualifications:MINIMUM EDUCATION REQUIRED:Graduate of Nursing ProgramMINIMUM EXPERIENCE...

Overview: As a Utilization Review Nurse, you will work under the direct supervision of the Supervisor, Utilization Review and Clinical Documentation Improvement, this role will be responsible for providing clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services....

Description:RESPONSIBLE FOR:The Care Manager is responsible for care coordination, progression of care, and proactive discharge planning and is accountable for expediting the timely and safe discharge for all patients in their case load.Qualifications:MINIMUM EDUCATION REQUIRED:Graduate of Nursing ProgramMINIMUM EXPERIENCE REQUIRED:Two (2) years of...

Case Manager RN 5x8 Days (40Hrs) Req ID 59545 Alaska RN license required in hand 1 year acute or subacute Case Management/Care Coordinator experience Review per Case Manager Clinical Track but NO UR EXPERIENCE NEEDED " Admission Criteria " Discharge Planning " Care Coordination " Utilize one of the following: Milliman Guidelines or InterQual Criteria (please...

Description:RESPONSIBLE FOR:The Care Manager is responsible for care coordination, progression of care, andproactive discharge planning and is accountable for expediting the timely and safe discharge for all patients in their case load.Qualifications:MINIMUM EDUCATION REQUIRED:Graduate of Nursing Program.MINIMUM EXPERIENCE REQUIRED:Two (2) years of...

Description:RN Care Manager -Full-time daysRESPONSIBLE FOR:The Care Manager is responsible for carecoordination, progression of care, and proactive discharge planningand is accountable for expediting the timely and safe discharge forall patients in their caseload.Qualifications:MINIMUMEDUCATION REQUIRED:Graduate of NursingProgramMINIMUM...

Who We Are: St. John’s Episcopal Hospital is the only hospital providing emergency and ambulatory care to the densely populated, culturally and economically diverse, and medically underserved populations of the Rockaways and Five Towns in southern Queens County and southwestern Nassau County, New York. Celebrating over 110 years of community care, the...

Job Description Job Description HCT is seeking an interim Director of Care Coordination for a 150+ bed hospital system in California. The responsibilities include: Providing oversight, direction and leadership of Care Coordination functions including utilization management, discharge planning, case management, length of stay management, and the...

Description: REGISTERED NURSE, Inpatient Care Manager Shift Info: e very other Friday-Saturday-Sunday 12 hour shifts Sign on Bonus Available RESPONSIBLE FOR: The Care Manager is responsible for care coordination, progression of care, and proactive discharge planning and is accountable for expediting the timely and safe discharge for all patients in their...

HCT is seeking an interim Director of Care Coordination for a 150+ bed hospital system in California. The responsibilities include:Providing oversight, direction and leadership of Care Coordination functions including utilization management, discharge planning, case management, length of stay management, and the appeals/denials process. Managing and...

Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review...