Milliman jobs in San Diego, CA

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Healthcare Analyst

Milliman - 35 reviews - San Diego, CA
Job Responsibilities Key responsibilities will include the following: Work on data loading for data warehouse projects. Provide analytic services, primarily

Prior Authorization Representative

Aetna - 2,444 reviews - San Diego, CA
Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria. The Prior Authorization Representative supports comprehensive coordination of medical...

Licensed Concurrent Review Consultant (CA MCD)

Aetna - 2,444 reviews - San Diego, CA
Utilization Review Experience/Knowledge of clinical guidelines, systems/tools such as Milliman and Interqual; The Concurrent Review Consultant utilizes clinical...

Care Specialist III - Pharmacy Benefits

Sharp Healthcare - 181 reviews - San Diego, CA
Ability to apply Health Plan, Milliman, National Comprehensive Cancer Network (NCCN) and other evidenced based criteria appropriately to referral requests under...

Case Manager I - Inpatient

Sharp Healthcare - 181 reviews - San Diego, CA
Experience with InterQual, Millimans Care Guidelines (MCG) and Allscripts. This position is located in San Diego County....

(RN) Ambulatory Care UM Case Manager

UC San Diego - 492 reviews - San Diego, CA
Midas, ECIN, Interqual and Milliman experience. Reporting to the Medical Group Managed Care UM Manager, the ambulatory case manager is responsible for...

AR II - UTILIZATION REVIEW - Full-Time - Day

Scripps Health - 304 reviews - San Diego, CA
Description Responsible for working assigned queues, including making review determinations for referrals/authorizations on internal criteria list level.

High Risk Case Manager

Community Health Group - 22 reviews - Chula Vista, CA 91910
Case management, disease management, or authorization referrals processing according to standard clinical (such as Milliman USA)....
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RN Hospital Care Coordinator (Travel)

HCTec - 13 reviews - San Diego, CA
$100,000 a year
InterQual OR Milliman experience is preferred. A large hospital network seeks responsible RN Case Managers to oversee our patient's needs and coordinate with...
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RN Complex Case Manager - Health Plan

CareNational - San Diego, CA 92108
$65,000 - $80,000 a year
License.Certification in Case Management (CCM) is preferred.Bachelor's Degree in Nursing (BSN) is a plus.Roughly 3-5 years acute care clinical nursing...
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