Utilization Management Reviewer - Behavioral Health (LMHC, LICSW) Massachusetts only!
Boston, Massachusetts
Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed ca...
5d
| Job Type | Full Time |
Clinical Appeal and Grievance Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
The role is an integral part of our Appeals and Grievance review process and will ensure clinical/pharmacy appeal case reviews meet contractual, regulatory, and business goals. The position collaborates with members of the Appeal and Grieva...
5d
| Job Type | Full Time |
Clinical Training and Auditing Coordinator, Intermediate
El Dorado Hills, California
Your Role The Clinical Training & Auditing team is in place to ensure the provision of care rendered to our most vulnerable population is safe and of quality, by DHCS standards. The Facility Site Review (FSR) team will report to the Clinica...
6d
| Job Type | Full Time |
Utilization Management Nurse, Consultant- Lead
Rancho Cordova, California
Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services depa...
6d
| Job Type | Full Time |
Utilization Management Nurse, Consultant- Lead
Long Beach, California
Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services depa...
6d
| Job Type | Full Time |
Clinical Training and Auditing Coordinator, Intermediate
Long Beach, California
Your Role The Clinical Training & Auditing team is in place to ensure the provision of care rendered to our most vulnerable population is safe and of quality, by DHCS standards. The Facility Site Review (FSR) team will report to the Clinica...
6d
| Job Type | Full Time |
Utilization Management Nurse, Consultant- Lead
El Dorado Hills, California
Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services depa...
6d
| Job Type | Full Time |
Clinical Training and Auditing Coordinator, Intermediate
Rancho Cordova, California
Your Role The Clinical Training & Auditing team is in place to ensure the provision of care rendered to our most vulnerable population is safe and of quality, by DHCS standards. The Facility Site Review (FSR) team will report to the Clinica...
6d
| Job Type | Full Time |
Utilization Management Nurse, Consultant- Lead
Woodland Hills, California
Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services depa...
6d
| Job Type | Full Time |
Clinical Training and Auditing Coordinator, Intermediate
Woodland Hills, California
Your Role The Clinical Training & Auditing team is in place to ensure the provision of care rendered to our most vulnerable population is safe and of quality, by DHCS standards. The Facility Site Review (FSR) team will report to the Clinica...
6d
| Job Type | Full Time |