Utilization Management Specialist

Job DescriptionThis role focuses on leading the implementation of initiatives aimed at enhancing UM operations, including provider redirection, cost control, and process automation.The ideal candidate will oversee projects aligned with company goals for medical utilization cost containment.Data Analysis & Performance TrackingWe are seeking an individual to...

OverviewJoin to apply for the Assistant Manager-Utilization Management role at Maxicare Healthcare Corporation.ResponsibilitiesOversee and implement initiatives aimed at improving UM operations, including but not exclusive to provider redirection, cost control, and process automation.Identify inefficiencies in UM workflows and propose data-driven and process...

OverviewJoin to apply for the Analyst-Utilization Management role at Maxicare Healthcare CorporationResponsibilitiesMeasure success through key performance indicators and other metricsProvide analysis and meaningful information supporting decision-making and action-planningAnalyze current processes and systems to identify inefficiencies and areas for...

Improve patient care by working as a Utilization Management specialist in a virtual environment.Key responsibilities include assessing and interpreting customer needs, requirements and medical records, as well as reviewing medical claims for medical necessity.Required skills and qualifications include:Active PHRN and USRN Mainland License1 year Bedside...

Location: Mt. Fuji, Japanese RestaurantPosition: UtilityType: Full-TimeAbout UsMighty King Chinese Restaurant is renowned for its authentic Chinese cuisine and exceptional service. We are looking for a reliable and hardworking Utility Worker to join our team and contribute to the smooth operation of our restaurant.Job Responsibilities:Cleaning: Maintain...

OverviewLead - Utilization Management role at Maxicare Healthcare CorporationResponsibilitiesIdentify urgent and priority operational business and utilization management issuesDesign, execute, and implement a team plan, together with Project Lead, innovative and pragmatic solutions aligned with the business's long-term strategic plansOversee and manage...

Unlock Career Growth with a Senior Management RoleJob Description:We are seeking an experienced senior manager to spearhead our utilization management projects. As a seasoned professional, you will oversee and implement initiatives that enhance operational efficiency and drive business outcomes.Main Responsibilities:Develop and execute strategies to improve...

Duties & ResponsibilitiesDemonstrably optimize healthcare utilization for enrolled clients, achieving cost savings and improved member health outcomes through a robust Utilization Management Program.Develop and Implement Client-Specific Utilization Management StrategiesEnhance Prior Authorization and Concurrent Review ProcessesStrengthen Case Management and...

JOB SUMMARY The General Services Utilities Engineering Officer shall be responsible for maintaining the sound engineering status of each clinic, creating solutions to problems, and monitoring existing conditions. This covers from basic to complex Electrical, Mechanical, Fire Protection, and Plumbing concerns. JOB DUTIES AND RESPONSIBILITIES ...

JOB SUMMARYThe General Services Utilities Engineering Officer shall be responsible for maintaining the sound engineering status of each clinic, creating solutions to problems, and monitoring existing conditions. This covers from basic to complex Electrical, Mechanical, Fire Protection, and Plumbing concerns.JOB DUTIES AND RESPONSIBILITIESGeneral Duties and...