Utilization Review Jobs in Evansville
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Search Results - Utilization Review Jobs in Evansville
Medix™Evansville
nursing role. You’ll work through clinical cases, review the information available, identify what is missing, determine the appropriate next step, and escalate when needed.
The work can touch prior authorization, utilization review, care coordination...
AdeccoEvansvilleadecco.com
services
• Perform prospective drug utilization reviews and identify medication-related concerns
• Maintain compliance with federal, state, and local pharmacy regulations
• Collaborate with prescribers and healthcare professionals to support positive...
TPI Global SolutionsEvansville
The Medical Director ensures compliance with NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of a multidisciplinary team for case and disease management and advises...
Medix™Evansville
brings proven experience conducting utilization reviews within a SNF, health plan, or managed care setting, alongside strong clinical judgment and the ability to collaborate effectively across interdisciplinary teams, healthcare providers, and payers...
TALENT Software ServicesEvansville
of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...
Well Behavioral HealthEvansville
including refill requests and
pharmacy coordination, within clinic protocols
• Provide services via telehealth consistent with 14 NYCRR Part 596
• Participate in quality improvement, utilization review, and peer review activities as required by
OMH...
OptumEvansville
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/assists in the direction...
360X StaffingEvansville
oversight, medical expertise, and operational support for physical health services. This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care...
BayOne SolutionsEvansville
and tuning methodologies.
• Participate in capacity planning, workload forecasting, and resource utilization reviews.
• Ensure high availability and disaster recovery strategies are performance-optimized and cost-effective.
• Manage multiple concurrent...
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