Utilization Manager Jobs in Oregon
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Search Results - Utilization Manager Jobs in Oregon
Legacy Health-Portland
RN - Utilization Management
US-OR-
Job ID: 24-38023
Type: Part Time - Benefitted
Homebased EE Oregon
Overview
Relocation Assistance Available
The Legacy nursing philosophy focuses on patients and their families. Our nurses embody...
AmeriHealth Caritas-Remote
Job Brief
The Dental Director Utilization Management Appeals, will be responsible for the appeals process of our members in PA, OH and MI. This is a remote role and does require a Pennsylvania license (DMD/DMS).
Your career starts now. We...
Legacy Health-Portland
Physician Advisor
US-OR-
Job ID: 23-35554
Type: Regular Full-Time
Homebased EE Oregon
Overview
The Physician Advisor provides medical direction/ guidance to the Care Management Department in the areas of Utilization Management, Clinical...
AllCare Health-Grants Pass
retirement, wellness programs, and telecommute, remote work, and flexible schedule options.SummaryThis position is responsible for providing efficient and quality utilization management services utilizing clinical knowledge to support achieving optimal...
AmeriHealth Caritas-Remote
at www.amerihealthcaritas.com.
Responsibilities:
Provide organizational leadership in the operational areas of utilization review, case management, related policy and practice initiatives, and network management. He/she will serves as the lead dentist on the medical...
Legacy Health-Portland
inpatient, emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management and resource management.
Working knowledge of Care Management models across the continuum.
Knowledge/Skills...
Optum-Portland
The Medical Directors activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package...
mindmatch.ai -
Legacy Health-Gresham
emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management and resource management.
Working knowledge of Care Management models across the continuum.
Knowledge/Skills:
Knowledge...
Assured Home Health-Portland
in the agencys utilization management model.
License Requirements
• Current RN licensure in state of practice
• Current CPR certification
• Current Drivers License, vehicle insurance, and access to a dependable vehicle or public transportation
Additional State...
mindmatch.ai -
AmeriHealth Caritas-Remote
and validates authorization of services, written clinical documentation of services received through Physical Health Services and Behavioral Health utilization management Departments, and information contained in the health care claims systems against claims...
Legacy Health-Portland
populations
• Ambulatory Care
Knowledge of levels of care throughout the health care continuum to include inpatient, emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management...
PharmaCord-Remote
state experience preferred.Fluent in English and Spanish is requiredNurseline triage, Call Center Utilization Management, Call Center Case Management, a plus.Case management or Clinical Trial Nurse experience, a plus.Bachelor's degree preferred.All...
UnitedHealth Group-Portland
review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company.
The Medical Director also provides...
mindmatch.ai -
Remote
and Microsoft Outlook required.
• Knowledge of medical claims and ICD-10, CPT, HCPCS coding preferred.
• Knowledge of utilization management/quality management case philosophies and reporting requirements; quality improvement methodologies preferred.
• Ability...
icims.com -
Remote
to manage multiple cases efficiently.
• Familiarity with relevant software and tools used in healthcare.
Desired Skills and Experience:
• Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable...
enlyte.com -
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