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This position is available fully remote in Washington State.
Job Summary
Responsible for administrative functions in processing Utilization Management (UM) organization determinations for services requiring authorization and hospital notification. Utilizes knowledge of Medicare and Medicaid guidelines in order to facilitate and comply with the UM processes in data entry of authorization requ...
POSITION SUMMARY:
The Utilization Review Authorization Coordinator Lead will work with Utilization Review Authorization Coordinators and other facility staff to coordinate the appropriate information and actions necessary to ensure proper authorizations are obtained for care of patients. Identify and review denial patterns while working with UR Managers, UR Educators, and Care Management Team t...
The Population Health Specialist I provides operational support for the Case Management, Condition Management, Quality, Wellness, Pharmacy, Government Relations, and Utilization Management Departments including, but not limited to, requesting and extracting medical records and provider outreach for HEDIS, Health Risk Assessments, Primary Care Provider Attributions, CIOX medical records, and inc...
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LOCATION: Remote – must live in or near Buncombe County, NC. Incumbent in this is required to reside in North Carolina or within 40 miles of the North Carolina border. This position requires travel.
GENERAL STATEMENT OF JOB
The 1915(i) Waiver Care Coordinator (“Care Coordinator”) is responsible for providing proactive intervention and coordination of care to eligible Vaya Health membe...
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Solar Maintenance Coordinator Remote Job - United States | Posted - 01/13/23 Apply Easy Apply Overview
* Work remotely to drive excellence i...
New
Summary
We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator I, you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests. Utilizes clini...
New
Summary
We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator I, you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests. Utilizes clini...
LOCATION: Remote – covers Franklin County
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervenes and coordinates care for Medicaid members not eligible for Tailored Care Management and who have complex care coordination...
LOCATION: Remote – covers Jackson County
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervenes and coordinates care for Medicaid members not eligible for Tailored Care Management and who have complex care coordination nee...
LOCATION: Remote – covers Alamance County
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervenes and coordinates care for Medicaid members not eligible for Tailored Care Management and who have complex care coordination ne...
LOCATION: Remote – covers Rowan County
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervenes and coordinates care for Medicaid members not eligible for Tailored Care Management and who have complex care coordination ne...
LOCATION: Remote – covers Wilkes County
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervenes and coordinates care for Medicaid members not eligible for Tailored Care Management and who have complex care coordination n...
LOCATION: Remote – must live in or near Buncombe County, North Carolina. The position must live in North Carolina or within 40 miles of the North Carolina border.
GENERAL STATEMENT OF JOB
Complex Care Coordinator (CCC) is responsible for knowing and implementing North Carolina Department of Health and Human Services standards and organizational policies.
CCC proactively intervene...
UR Authorization Coordinator - Remote
Mesa, AZ, USA Req #2576 Tuesday, June 20, 2023 Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing cris...
Salary : $57,708.00 - $66,792.00 Annually
Location : Denver, CO
Job Type: Full Time
Job Number: PAA CAIC 00539 04/2025
Department: Department of Natural Resources
Division: Executive Director's Office
Opening Date: 04/08/2025
Closing Date: 4/30/2025 11:59 PM Mountain
FLSA: Determined by Position
Type of Announcement: This position is open only to Colorado state residents.
Hiring Pay Rate: Emplo...
This posting is only open to residents of the State of Colorado at the time of submitting your application.
Consider joining the dedicated people of the Colorado Department of Natural Resources. It’s our mission to manage and conserve Colorado’s natural resources for the benefit of people today – and tomorrow. That means we have to balance development with conservation so the state we all ...
