Utilization Management Salary at Anthem Blue Cross BETA

Job Description Job Description ESSENTIAL DUTIES: Inpatient Support Coordinator: Calling hospitals to verify if patients are still in the hospital or have discharged. Entering and processing hospital face sheets. Maintaining an updated census for assigned case manager. Issuing approval letters for admissions Discharge Planning Coordinator Reviewing hospital discharge orders received for completeness Forwarding orders to appropriate case manager for review and decision Issuing hard copy authorizations and making all arrangements for approved services (ie. DME, home health, consults, follow up visits, radiology, etc…) MINIMUM REQUIREMENTS Understanding of basic medical terminology Organized, efficient and possess superior attention to detail Punctual, prepared and able to meet or beat deadlines Excellent written and verbal communication skills Medical office or hospital admitting/medical records department experience a plus For Transition of Care Coordinator position – Spanish Speaker is

[Administrative Assistant / Remote] - Anywhere in U.S. / Up to $28.82 per hour / Competitive benefits - As an Administrative Correspondence Processor at Molina Healthcare Services, you will: Provide clerical, data entry and/or telephone support for the Utilization Management team; Manage the workflow for responses to incoming authorization requests and correspondence from Molina members and providers, collaborating with team members to provide timely replies; Generate, process, track and store authorization requests and correspondence related to Care Access and Monitoring approvals and denials and other integrated Molina programs; Enter member demographic data and provider information updates into appropriate systems...Hiring Immediately >>

Immediate need for a talented Registered Nurse Utilization Management. This is a 02+months contract opportunity with long-term potential and is located in Los Angeles, CA(Onsite). Please review the job description below and contact me ASAP if you are interested. Job ID: 24-31461 Pay Range: $86 - $95/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Requirements and Technology Experience: Key skills; Case management Outpatient Experience, ED, One should have 1.5 years of experience in a supervisory role. Supervise and manage the case management team in the Emergency Department (ED) for outpatient care coordination. Oversee complex patient cases, ensuring quality care and optimal patient outcomes. Collaborate with physicians, healthcare providers, and clinical teams to ensure effective care delivery. Drive operational efficiency and improve the patient experience through

When you join the Huntington Hospital team, you are aligning yourself with an organization whose values drive our philosophy of compassionate community care. Over the past 129 years, we’ve grown from a small 16-bed hospital to a nationally recognized healthcare leader with 619 beds. As part of our commitment to providing equitable, high-quality care to all members of our community, we embrace differences and work hard to create a place of belonging for our patients and our employees. When you join the Huntington family, you’ll be empowered to enact change that continuously improves our ability to deliver world-class care, with kindness and dignity, to all who need it. ** Internal Workers – Please log into your Workday account to apply ** Huntington Hospital Employee Login Compensation Range: Anticipated Base compensation rate is in the range of $44.01 - $44.01 / Hour depending on qualifications and experience. Department: 875100 Case Management Expectations: This position involves disc

[Administrative Assistant / Remote] - Anywhere in U.S. / Up to $28.82 per hour / Competitive benefits - As an Administrative Correspondence Processor at Molina Healthcare Services, you will: Provide clerical, data entry and/or telephone support for the Utilization Management team; Manage the workflow for responses to incoming authorization requests and correspondence from Molina members and providers, collaborating with team members to provide timely replies; Generate, process, track and store authorization requests and correspondence related to Care Access and Monitoring approvals and denials and other integrated Molina programs; Enter member demographic data and provider information updates into appropriate systems...Hiring Immediately >>

[Administrative Assistant / Remote] - Anywhere in U.S. / Up to $28.82 per hour / Competitive benefits - As an Administrative Correspondence Processor at Molina Healthcare Services, you will: Provide clerical, data entry and/or telephone support for the Utilization Management team; Manage the workflow for responses to incoming authorization requests and correspondence from Molina members and providers, collaborating with team members to provide timely replies; Generate, process, track and store authorization requests and correspondence related to Care Access and Monitoring approvals and denials and other integrated Molina programs; Enter member demographic data and provider information updates into appropriate systems...Hiring Immediately >>

** Internal Workers - Please log into your Workday account to apply ** Huntington Hospital Employee Login Compensation Range: Anticipated Base compensation rate is in the range of $0.00 - $0.00 / Year depending on qualifications and experience. Department: 875200 Quality Assurance Expectations: The Physician Advisor is responsible for ensuring the appropriateness of patient care through utilization management. This role involves conducting thorough secondary reviews of patient cases to evaluate care appropriateness and identify improvement opportunities while interfacing with utilization management staff to clarify patient statuses. EDUCATION: MD or DO degree from an accredited medical school EXPERIENCE/TRAINING: Minimum of 2 years of clinical experience in a hospital or healthcare setting; previous experience in utilization management or healthcare administration is preferred. LICENSES/CERTIFICATIONS: Required: Current unrestricted Physician and Surgeon A with Furnishing License issue

Immediate need for a talented Utilization Management Case manager . This is a 03+months contract opportunity with long-term potential and is located in Los Angeles, CA(Onsite). Please review the job description below and contact me ASAP if you are interested. Job ID: 25-65809 Pay Range: $85 - $100/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Requirements and Technology Experience: Skills-Strong Case management experience with Inpatient acute care (Hospital) Experience within Appeals and Grievance, Utilization and conducting investigations. RN Case Manager Hospital setting Acute care InterQual RN active License Must have 2+ years of experience in case management. Must have experience with hospital setting. Must have experience with InterQual or MCG, EPIC, Cerner. One should have an active RN License. Must have experience with Acute care. Our client is a leading Heal