Utilization Manager Jobs in North Dakota
1 - 12 of 12
Search Results - Utilization Manager Jobs in North Dakota
CommunityCare-Fargo-
to support timely utilization decisions
• Provide clinical consultation on complex medication requests and coverage determinations
• Support development and maintenance of medical drug utilization management programs
• Develop and maintain evidence-based...
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HealthSource Partners-Bismarck-
Participate in quality improvement and utilization management initiatives.
• Assist with audits, accreditation activities, and regulatory reviews as needed.
• Support efforts to improve patient outcomes and operational efficiency.
QualificationsRequired...
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CommunityCare-Bismarck-
to support timely utilization decisions
• Provide clinical consultation on complex medication requests and coverage determinations
• Support development and maintenance of medical drug utilization management programs
• Develop and maintain evidence-based...
Read more
Humana Inc-Bismarck-appcast.io-
on quality management, utilization management, and acute inpatient rehabilitation.
• Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid, or other medical management organizations, hospitals/ Integrated Delivery Systems...
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Huron Consulting Group-Fargo-
quality incentive programs, and network optimization
• Experience leading complex healthcare analytics and modeling (e.g., HCC risk adjustment, RAF optimization, clinical risk stratification, cost trend analysis, utilization management, population health...
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Salient-Fargo-mindmatch.ai-
and the claim lifecycle, including basic adjudication and 837/835 concepts (NYS Medicaid experience a plus).
• Exposure to health data formats such as enrollment, services, lab, and pharmacy.
• Awareness of utilization management, care coordination, quality...
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Huron Consulting Group-Bismarck-
quality incentive programs, and network optimization
• Experience leading complex healthcare analytics and modeling (e.g., HCC risk adjustment, RAF optimization, clinical risk stratification, cost trend analysis, utilization management, population health...
Read more
Salient-Bismarck-mindmatch.ai-
and the claim lifecycle, including basic adjudication and 837/835 concepts (NYS Medicaid experience a plus).
• Exposure to health data formats such as enrollment, services, lab, and pharmacy.
• Awareness of utilization management, care coordination, quality...
Read more
UnitedHealth Group-Fargo-
Overview
As Medical Director, you guide clinical coverage determinations within Enterprise Clinical Services, collaborating with leadership to ensure high-quality, cost-effective patient care. You lead utilization management activities and engage...
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UnitedHealth Group-Bismarck-
Overview
As Medical Director, you guide clinical coverage determinations within Enterprise Clinical Services, collaborating with leadership to ensure high-quality, cost-effective patient care. You lead utilization management activities and engage...
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UnitedHealth Group-Bismarck-
Overview
In this role you support authorization decisions for psychiatric and chemical dependency care, working within Utilization Management to ensure medical necessity and efficient care transitions. You will handle data entry, coordination...
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UnitedHealth Group-Fargo-
Overview
In this role you support authorization decisions for psychiatric and chemical dependency care, working within Utilization Management to ensure medical necessity and efficient care transitions. You will handle data entry, coordination...
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