Utilization management jobs

Business Analyst-Utilization Management /Prior Authorization workflows

Hybrid in Eagan, Minnesota

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Today

Looking to fill in 2 healthcare business analyst contract roles in Eagan MN with Utilization Management and Prior Authorization workflows for hybrid contract role in Eagan Minnesota 55121 Hybrid -onsite 2 days per week, with Wednesdays as team anchor day, and additional day per week of choice. (Buildings are closed on Fridays) If interestedd apply with word document resume , work authorization ,current location and availability for onsite work. 1)Responsible for the analysis, development, suppor

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Contract

Depends on Experience

Senior Data Scientist - Utilization Management

Remote or Wellesley, Massachusetts

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary At CVS/Aetna, we're pioneering a total

Full-time

USD 101,970.00 - 222,480.00 per year

Epic Certified Tapestry Analyst

No location provided

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Today

Our nationwide remote client is seeking (4) Certified Epic Tapestry Analysts for a 3-6 month+ engagement and contract to hire starting in February. Requires Epic Tapestry certifications with CEE's. The 3 roles: Epic Tapestry Medical Management - Utilization Management (UM), Case Management (CM), Provider configuration.Epic Tapestry Claims (or) Membership AnalystEpic Tapestry Health Plan Architect Must be able to work as a W2. This position is not open to vendors To learn more about this and ot

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Full-time

Non-invasive Cardiology, Non-Invasive Cardiologist

Glen Burnie, Maryland

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Today

Job Description Company Description The University of Maryland Baltimore Washington Medical Center (UM BWMC), a member of the University of Maryland Medical System (UMMS), is seeking a Board-Certified/Board-Eligible Non-Invasive Cardiologist to join its rapidly growing cardiology practice in Glen Burnie, Maryland. Job Description Established team of 12 physicians, 11 APPs, and 4 nursesOffice- and hospital-based, single-specialty groupAverage patient volume: ~30 patients/day split between office

Full-time

Compensation information provided in the description

MCNCE VISTA- Veteran & Military Student Success Data Analyst

Montana

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Today

MCNCE VISTA- Veteran & Military Student Success Data Analyst The Military and Veteran's Service Office (MVSO) located on the University of Montana campus in Missoula supports student veterans and their families. UM is home to nearly 1000 military-affiliated students, and UM is the nation's 3rd highest percent of veterans on campus per capita in the nation. The goal of the VISTA project is to help student veterans and their families break the cycle of poverty and low-income occupations through i

Full-time

Allergy & Immunology, Postdoctoral Fellow - Biochemistry and Virology

Columbia, Missouri

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Today

Job Description The Lange Lab at the University of Missouri seeks a highly motivated postdoctoral scientist with a strong background in biochemistry and virology. A competitive candidate should be team-oriented with strong interpersonal skills, reliable, detail-oriented, creative, and have a strong record of research productivity. Key Responsibilities Assist with laboratory management, organization, and daily maintenance. Work independently to design and execute experiments and maintain hard-cop

Full-time

Physician Advisor, Physician Advisor - Sentara Obici Hospital

Norfolk, Virginia

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Today

Job Description Overview: The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the centralized system Utilization Review (UR) process for Sentara hospital facilities. The Physician Advisor serves an important role in ensuring compliant hospital status/billing for hospital patients and strengthening relationships between Clinical Revenue Cycle, UR, hospita

Full-time

Physician Advisor, Physician Advisor - Sentara Virginia Beach General Hospital

Norfolk, Virginia

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Today

Full-time

Manager, Epic Payer Platform and Cloud Infrastructure (AWS)

Remote or St. Louis, Missouri

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Today

Systems Analysis Manager - Epic Payer Platform (AWS) We're building the future of connected healthcare-and we're looking for a seasoned application development leader to help lead the way. In this role, you'll shape how payer and provider systems work together, powering seamless, secure, and scalable experiences through Epic and AWS. You'll bring deep expertise, curiosity, and care-balancing high standards with compassion for the people and teams you support. Responsibilities (Outcomes & Strate

Full-time

Facets Benefit Configuration Consultant

Remote or Georgia

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Today

Stellar Consulting Solutions is a boutique business & technology consulting company headquartered in Atlanta, GA. We deliver high quality, agile, and experienced workforce for niche technology projects of any scale. We help forward thinking clients to solve specific problems by understanding their needs and align talent that can move fluidly to match skill supply and demand on a real-time basis. Stellar Consulting has a unique combination of technical and digital skills to recruit, engage, and

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Contract, Third Party

$70

Tapestry UM Analyst

Remote

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Today

Role: Tapestry UM Analyst Job Description: We are seeking an experienced Epic Tapestry Utilization Management Analyst to design, build, optimize, and support UM processes focused on authorizations and referrals. The ideal candidate is Epic Tapestry UM Certified, has practical experience with Tapestry Care Link, and is adept at translating payer and network operations needs into scalable Epic solutions. You will partner with UM leadership, clinical reviewers, provider relations, care management,

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Contract

55 - 60

Clinical Advisor

Southborough, Massachusetts

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Today

Job DescriptionClinical Advisor Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage of life. Success radiates across all levels of our organization, driven by competitive benefits and a strong focus on employee wellness, we aim to support all aspects of employee growth. Characterized by curiosity, innovation, and an entre

Full-time

Engineer (Sr./Specialist) - Avionics and Electrical Systems Unit Member

Wichita, Kansas

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Today

JOB SUMMARY: The Avionics and Electrical Systems UM is responsible for ensuring that all engineering type design is compliant with applicable government regulations utilizing the Textron Aviation ODA processes. Duties include but are not limited to: Coordinating within the ODA and FAA, supporting resolution of certification issues, determination of certification basis, writing and reviewing certification plans and test plans, witnessing certification testing, documenting testing results and maki

Full-time

Senior Systems Safety Engineer

Mesa, Arizona

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Today

Overview We are seeking a full-time Senior Aircraft Systems Safety Engineer in our Mesa,AZ location. In this role, you will be responsible for overseeing the aircraft system safety assessment process and generating and approving the required analyses in support of Garmin STC projects. Essential Functions Work with system safety analysts to establish the system safety approach and documentation necessary to show compliance for Garmin STCSupport the generation and UM approval of System Safety Ass

Full-time

Certification Staff Engineer

Fort Worth, Texas

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Today

We're more than aviation experts, we're pioneers. We challenge what's possible. From breaking the sound barrier to advanced tiltrotor systems. Today, Bell is shaping the future of aviation through specialized engineering. And we want you. We are developing the future of Army Aviation with the Bell Future Long-Range Assault Aircraft (FLRAA) MV-75, part of the US Army's Future Vertical Lift (FVL) modernization effort. We are also developing the Bell 525 Relentless, and Bell's High-Speed Vertical

Full-time

Chief Medical Officer

Hartford, Connecticut

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26d ago

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide m

Full-time

USD 262,900.00 - 404,200.00 per year

Aetna Technology Medicaid Director Product Portfolio

Remote or Downers Grove, Illinois

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Today

Full-time

USD 144,200.00 - 288,400.00 per year

Google Cloud Platform - Google Cloud Platform and Power Platform Developer

Remote or Irving, Texas

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Today

Full-time

USD 60,300.00 - 145,860.00 per year

Sr Aerospace Engineer - Aircraft Certification

Remote or Plano, Texas

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Today

The ISR (Intelligence, Surveillance & Reconnaissance), Aviation, and Security (IAS) business area is a leader in ISR and aviation, it is a leading prime manned and unmanned aircraft systems integrator for innovative, high-performance ISR and aviation systems. Its end-to-end Command, Control, Computers, Communications and Intelligence, Surveillance & Reconnaissance (C4ISR) capabilities encompass design, integration, test, certification, ground/flight training and complete logistics support. IAS t

Full-time

Data Analyst II Healthcare Analytics

Remote or Michigan

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Today

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v

Full-time

USD 56,200.00 - 101,000.00 per year

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Utilization management jobs