Medical Director, Utilization Management-Remote

in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care... and Milliman guidelines. Act as a liaison between the medical staff, utilization review and third-party payers to effectively...

Lugar: Orange, CA | 24/09/2026 17:09:32 PM | Salario: S/. No Especificado | Empresa: Alignment Healthcare

Registered Nurse - Case Manager

;Discharge Planning;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR... Utilize Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding...

Lugar: Irvine, CA | 24/09/2026 02:09:33 AM | Salario: S/. No Especificado | Empresa: Apidel Technologies

RN Care Manager (Clinic)

in a managed care outpatient or community environment, preferred. Recent working knowledge of Milliman Care Guidelines, preferred...

Lugar: Reno, NV | 24/09/2026 01:09:25 AM | Salario: S/. No Especificado | Empresa: TMC Bonham Hospital