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Nemours Logo
Ambulatory Administrative Operations Manager
Nemours

Pensacola, Florida

NEW!
AdventHealth Logo
RN PCU Nights
AdventHealth

Calhoun, Georgia

NEW!
University of Maryland Medical System Logo
New Graduate Registered Nurse (RN), Med Surg, Nights, $10K Sign-on Bonus!
University of Maryland Medical System

Baltimore, Maryland

NEW!
WakeMed Health & Hospitals Logo
Surgical Technologist I, OR
WakeMed Health & Hospitals

Raleigh, North Carolina

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Harris Health System Logo
Cancer Registry Manager
Harris Health System

Houston, Texas

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AdventHealth Logo
Registered Nurse Seasonal ICU Medical Nights
AdventHealth

Dade City, Florida

NEW!
University of Maryland Medical System Logo
Senior Clinical Trial Coverage Analyst
University of Maryland Medical System

Baltimore, Maryland

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Denver Health Logo
RN Registered Nurse Case Manager - Safe Center
Denver Health

Denver, Colorado

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WakeMed Health & Hospitals Logo
PA or NP, Fellow - Cardiology
WakeMed Health & Hospitals

Raleigh, North Carolina

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Carle Health Logo
Critical Care - Advanced Practice Provider
Carle Health

Peoria, Illinois

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AdventHealth Logo
Child Life Specialist Medical Surgical Unit
AdventHealth

Orlando, Florida

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Vanderbilt Health Logo
Recovery Coach (Certified Peer Recovery Specialist)
Vanderbilt Health

Nashville, Tennessee

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AdventHealth Logo
Pediatric Cardiac Sonography Educator Part Time
AdventHealth

Orlando, Florida

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Vanderbilt Health Logo
Pediatric Inpatient Pharmacy Certified Technician Coordinator, Day Shift
Vanderbilt Health

Nashville, Tennessee

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BJC HealthCare Logo
Sr. Healthcare Informatics Specialist
BJC HealthCare

Saint Louis, Missouri

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Penn State Health Logo
Medical Assistant I - Cornerstone Family Health
Penn State Health

Lititz, Pennsylvania

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Labcorp Logo
Sample Management Intern
Labcorp

Singapore, Singapore

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Northeast Georgia Health System Logo
Certified Medical Assistant CMA - Northeast Georgia Physicians Group NGPG - West Jackson - FT Days
Northeast Georgia Health System

Hoschton, Georgia

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Harris Health System Logo
Sales Rep - Marketplace Inside
Harris Health System

Houston, Texas

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AdventHealth Logo
Medical Assistant Primary Care
AdventHealth

Winter Haven, Florida

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Baylor Scott & White Health Logo
Patient Services Specialist
Baylor Scott & White Health

Fort Worth, Texas

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CHRISTUS Health Logo
OT, Occupational Therapist - Rehabilitation Hospital - Full Time
CHRISTUS Health

Texarkana, Texas

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CHRISTUS Health Logo
Manager Environmental Services - Housekeeping
CHRISTUS Health

Alamogordo, New Mexico

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BJC HealthCare Logo
Clinical Nurse High Risk Cardiac
BJC HealthCare

Belleville, Illinois

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Labcorp Logo
Health Educator (Wellness Worker) - North Central Region
Labcorp

Cleveland, Ohio

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Utilization Management Specialist
DescriptionUnder the direction and supervision of the Utilization Management Manager, the Utilization Management Specialist is responsible for overseeing the research, resolution and workflow development of out-of-network (OON) referral requests. This role reviews OON referral requests from members and providers, acting as a key liaison to facilitate timely, accurate, and efficient processing. In addition, the UM Specialist will:Ensure compliance with organizational guidelines and regulatory standards, promoting quality care access for members while optimizing network utilization and reducing unnecessary out-of-network expenses


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