Utilization Review Jobs in Milwaukee
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Search Results - Utilization Review Jobs in Milwaukee
Gainwell-Milwaukee
and technical development academies
Responsibilities
• Provide clinical guidance on policies, drug utilization, and pharmacy operations
• Perform clinical evaluations of medication therapy including prior authorization reviews and DURs
• Conduct peer-to-peer...
Molina Healthcare-Milwaukee
and externally.
• Responsible for investigation of adverse incidents and quality of care concerns.
• Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications.
• Provides...
appcast.io -
UnitedHealth Group-Milwaukee
or Marriage and Family Counseling or Licensed Ph.D. level Psychologist (independently licensed)
• Board certification as a Behavior Analyst (BCBA) and state licensure as required
• 3+ years of Managed Care and/or Utilization Review experience
• 3+ years...
Milwaukee
Account Management, Sales and Engineering, and Implementations.
Your role in our mission
• Pre:payment and post:payment versions of the following solutions: Clinical Claim Reviews (DRG Audit, Itemized Bill Review, Place of Service, Utilization Review...
tiptopjob.com -
Cummins-Milwaukee
generation applications
• Lead project planning sessions with internal stakeholders to define scope, objectives, milestones, and performance goals
• Develop cross-functional schedules and resource plans to meet timelines and optimize utilization
• Review...
TrackFive-Racine (WI), 22 mi from Milwaukee
health, administrative, and security teams
• Participate in quality assurance, peer review, and performance improvement activities
• Address clinical risk management, utilization review, and medical grievances as needed
About Adelphi Locums
Adelphi...
UnitedHealth Group-Milwaukee
requirements
• 5+ years of people leadership in a healthcare setting
• 3+ years in training program development, QA operations, or organizational education
• 3+ years in utilization management operations or utilization review
• 3+ years working knowledge...
Encompass Health Rehabilitation Hospital of Nittany Valley-Zion (IL), 41 mi from Milwaukee
Ensure accuracy of discharge and payor-related information in the patient record
• Participate in utilization review process: data collection, trend review, and resolution actions.
• Participate in case management on-call schedule as needed...
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