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RN Manager - Care Management
EvergreenHealth - 36 reviews - Kirkland, WA
Must use and support access to additional Care Management software tools such as CDR2 and Milliman. Facilitates patient care including organization and...
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Utilization Management Nurse
Clover Health - San Francisco, CA
2-3 years experience in a hospital setting, acute care, direct care experience preferred OR experience as case manager, care coordinator, concurrent review...
Easily apply
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Care Review Clinician
The Maxis Group - Columbus, OH
Skilled care, acute rehab and long-term acute care. Nurses working at the facilities where members are being care for will be sending over clinical information...
Easily apply
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COMMUNITY HEALTH WORKER LEAD - CARE MANAGEMENT

Epic Management - 15 reviews - Redlands, CA 92374
Ability to learn about guidelines and regulations relevant to case management and utilization management, including Medicare, DMHC, NCQA, and Milliman Care...
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Clinical Services Leader

Humana - 1,904 reviews - Fayetteville, AR
Who will manage, execute and monitor care improvement programs, including oversight of clinicians responsible for oversight of integrated care delivery through...

Care Transition Coordinator

Mercy Health - 150 reviews - Toledo, OH
Working knowledge of Milliman Care Guidelines and Interqual Criteria. Knowledgeable of Acute Care Case Management regulatory and compliance guidelines....

Onsite Discharge Care Manager - Newark, DE

UnitedHealth Group - 3,953 reviews - Newark, DE
Familiarity with Milliman criteria guidelines. Arrange alternative care services; Identify and evaluate delays in care....

Care Review Clinician

The Maxis Group - Columbus, OH
Skilled care, acute rehab and long-term acute care. Nurses working at the facilities where members are being care for will be sending over clinical information...
Easily apply

AMBULATORY CARE MANAGER - CARE MANAGEMENT

Epic Management - 15 reviews - Redlands, CA 92374
Management, including Medicare, DMHC, NCQA, and Milliman Care Guidelines. Care setting required. Principles and practices of health care, health care systems,...
Easily apply

Clinical Practice Guideline Coordinator

Valley Medical Center - 72 reviews - Renton, WA
$74,880 - $87,360 a year
Experience using online InterQual and Milliman guidelines preferred.6. Knowledge of hospital clinical practice standards for health care providers.2....

DENIAL/APPEALS COORD

Geisinger Health System - 67 reviews - Bloomsburg, PA
Remains knowledgeable of medical necessity criteria which may include InterQual/ Milliman. Remains knowledgeable of the state and federal guidelines in regard...

CARE MANAGER - SELECT

Beth Abraham Family of Health Services - 3 reviews - Bronx, NY
Coordinates care with the member, family and care team as required. The care manager coordinates the care and services delivered to selected member populations:...

RN Care Manager - Integrated Care

Magellan Health - 52 reviews - Tampa, FL 33617
Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective...
Utilization Review Specialist - Physician Advisory Services
Order to identify and support the appropriate level of care. Perform initial admission and continued stay reviews utilizing InterQual and Milliman using...
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RN - Case Manager (San Francisco)
Thomson Alliance, Inc - San Francisco, CA
In conjunction with physicians, develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of...
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Company with Milliman Care Guidelines jobs
EvergreenHealth is an integrated two-hospital health care system offering a breadth of services and programs.