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Milwaukee, Wisconsin
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operational management and oversight of integrated Healthcare Services (HCS) teams responsible for providing ... effective utilization of services, management of targeted member population, and triage activities
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Long Beach, California
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oversees one of the following key Healthcare Services functions: case management/disease management/care ... This is a fully remote role. The Director of Healthcare Services position will be overseeing the
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United States
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, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk ... leadership and guidance for utilization management and case management programs for mental health and
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Phoenix, Arizona
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leadership in the development and execution of the Plan’s disease management, case management, utilization ... , including such programs as Quality Improvement, Utilization Management, Care Management, Predictive Modeling
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Richmond, Virginia
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, Healthcare Services provides operational management and oversight of integrated Healthcare Services (HCS ... productivity, cost effective utilization of services, management of targeted member population, and triage
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United States
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appropriateness and medical necessity of healthcare services provided to members, targeting improvements in ... utilization practices, guideline usage, pharmacy utilization and effective resource management.
Develops
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Bothell, Washington
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healthcare services provided to members, targeting improvements in efficiency and satisfaction for patients ... , pharmacy utilization and effective resource management.
Develops and implements a Utilization
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Long Beach, California
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Job Description
Job Summary
Molina Healthcare Services (HCS) works with members ... education and experience
Required Experience
7 years of utilization and/or case management
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Bothell, Washington
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appropriateness and medical necessity of healthcare services provided to members, targeting improvements in ... utilization practices, guideline usage, pharmacy utilization and effective resource management.
Develops
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United States
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necessity of healthcare services provided to members, targeting improvements in efficiency and satisfaction ... usage, pharmacy utilization and effective resource management.
Develops and implements a
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United States
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, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management ... appropriateness and medical necessity of healthcare services provided to members, targeting improvements in
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Glen Allen, Virginia
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Services provides operational management and oversight of integrated Healthcare Services (HCS) teams ... productivity, cost effective utilization of services, management of targeted member population, and triage
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United States
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Behavioral Health Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of ... interview process._**
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS
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New York, New York
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presents healthcare utilization and cost containment reports and makes recommendations based on relevant ... /performance management metrics
Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing
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United States
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healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes
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United States
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, Concurrent Review/ Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines ... Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess
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United States
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JOB DESCRIPTION
Job Summary
Molina Pharmacy Services/Management staff work to ... requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy
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Nebraska
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related to utilization management, pharmacy, quality of care, and correct coding.
• Independently ... management experience in a managed healthcare setting.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS
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Salt Lake City, Utah
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related to utilization management, pharmacy, quality of care, and correct coding.
• Independently ... management experience in a managed healthcare setting.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS
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Long Beach, California
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DESCRIPTION**
Job Summary
Molina Healthcare Services (HCS) works with members, providers and ... /SKILLS/ABILITIES**
In collaboration with others, plans and executes internal Healthcare Services
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Dallas, Texas
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JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with ... executes internal Healthcare Services projects and programs involving department or cross-functional teams
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Dallas, Texas
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JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with ... executes internal Healthcare Services projects and programs involving department or cross-functional teams
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Los Angeles, California
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and resolve issues related to utilization management, pharmacy, quality of care, and correct coding ... management, or project management experience in a managed healthcare setting.
**REQUIRED EXPERIENCE
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Troy, Michigan
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& CSST resolution support, and National Contract Management support services.
• Serves as a ... and resolve issues related to utilization management, pharmacy, quality of care, and correct coding
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United States
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, Concurrent Review/ Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines ... process.**
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works
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United States
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, Concurrent Review/ Utilization Review / Utilization Management and knowledge of InterQual / MCG guidelines ... process.**
JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works
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United States
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JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with ... Utilization Management (UM) and MLTC/LTC experience are highly preferred. Additional experience with appeals
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United States
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Authorizations, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. MULTI ... during our interview process._
JOB DESCRIPTION
Job Summary
Molina Healthcare
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United States
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JOB DESCRIPTION
Job Summary
Molina Pharmacy Services/Management staff work to ... authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management
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United States
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JOB DESCRIPTION
Job Summary
Molina Healthcare Services (HCS) works with ... in Washington State and Utilization Management (UM) experience is highly preferred* . *_Further
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