Landmark Health - Remote +1 location3.0

Experience dealing with UM standards, NCQA requirements, CMS guidelines, Milliman guidelines; Do you want to make a difference in healthcare?...

Estimated: $99,000 - $140,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Christus Health - San Antonio, TX 3.8

Familiarity with InterQual, Milliman, Meditech, and Midas preferred. This position promotes effective and efficient use of resources for both the patient and...

Estimated: $51,000 - $65,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Signature Performance, Inc - Marysville, CA 3.3

Knowledge, skills and computer literacy to interpret and apply medical care criteria, such as InterQual or Milliman Ambulatory Care Guidelines....

Estimated: $45,000 - $58,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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St. Joseph Medical Center - Houston, TX 3.7

Knowledge of InterQual Level of Care and Milliman Criteria. The Case Management Denials Coordinator assumes responsibility and accountability for continuous...

Estimated: $52,000 - $76,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Aetna - Chantilly, VA 3.8

Experience and knowledge required in clinical guidelines, systems and tools i.e., Milliman, Interqual. The Care Management Coordinator services Aetna Better...

Estimated: $43,000 - $58,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Humana - Virginia 3.7

Knowledge of Milliman or Interqual. The Case Manager in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or...

Estimated: $55,000 - $75,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Milliman - Philadelphia, PA 3.7

Associate Actuary, for Milliman Inc. Associate Actuary will be responsible for financial & statistical analysis for insurance clients, including financial...

Estimated: $98,000 - $120,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Humana - California +1 location3.7

Description The Telephonic Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain...

Estimated: $97,000 - $130,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

myNEXUS - Brentwood, TN 3.1

Prior experience using evidence-based clinical guidelines (e.g., Milliman, InterQual) is preferred. This is a full time position working in our Brentwood,...

Estimated: $130,000 - $180,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

McBee - Portland, OR 

Knowledge of InterQual and/or Milliman criteria is required. The Utilization Review Nurse position requires concurrent review of emergency department admissions...

Estimated: $72,000 - $93,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Humana - Kentucky 3.7

Knowledge of Milliman or Interqual. The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members'...

Estimated: $56,000 - $75,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Humana - Phoenix, AZ 3.7

Description The Telephonic Front End Review Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures,...

Estimated: $57,000 - $75,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Provider Resources Inc - United States 4.1

One year or more of utilizing InterQual and/or Milliman guidelines against inpatient services experience is preferred. Medical Review Nurse....

Estimated: $59,000 - $83,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Humana - Washington, DC 3.7

Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical...

Estimated: $58,000 - $79,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

MetroPlus Health Plan - New York, NY 3.2

Requires knowledge of evidence-based guideline tools (InterQual, Milliman) for utilization management....

$140,000 - $150,000 a year

Milliman - Tampa, FL 3.7

The Milliman – Tampa Team is a practice within Milliman, Inc., one of the largest actuarial consulting firms in the world....

Estimated: $73,000 - $100,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Provider Resources Inc - United States 4.1

One year or more of utilizing InterQual and/or Milliman guidelines is preferred. Reporting to the Medical Review Manager, the Medical Review Nurse (MRN) will...

Estimated: $65,000 - $88,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Hawaii Medical Service Association - Kapolei, HI 3.5

HMSA annually updated medical and drug policies, medical protocols, National Comprehensive Cancer Network, Milliman Care Guidelines, Drugdex, etc. to determine...

Estimated: $51,000 - $73,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Berkeley Research Group, LLC - United States 3.5

Overview Berkeley Research Group (BRG) works with standalone community hospitals, multihospital health systems, and major academic medical centers to achieve...

Estimated: $82,000 - $100,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Healthfirst - United States +1 location3.5

Interqual and/or Milliman knowledge. The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification,...

Estimated: $59,000 - $80,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

The Nevill Group - Oak Ridge, MO 

Knowledge in areas such as InterQual Level of Care Criteria and Milliman & Robertson Criteria as well as knowledge of third party payer regulations related to...

Estimated: $62,000 - $86,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Berkeley Research Group, LLC - United States 3.5

Overview Berkeley Research Group works with standalone community hospitals, multihospital health systems, and major academic medical centers to achieve...

Estimated: $86,000 - $120,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Provider Resources Inc - United States 4.1

Knowledge of Interqual screening criteria and MCG (formerly Milliman Care Guidelines). Reporting to the Provider Resources, Inc (PRI) Chief Medical Officer and...

Estimated: $120,000 - $170,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Landmark Health - Rockland, MA 3.0

Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful....

Estimated: $110,000 - $150,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Southern California Hospitals at Culver City - Culver City, CA 3.1

Proficiency with Milliman Care Guidelines or Interqual preferred. RN - Case Manager....

Estimated: $73,000 - $94,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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River City Medical Group - Sacramento, CA 

Performs concurrent review (possibly onsite) for inpatient and/or outpatient and case management to ensure appropriateness of admission, continued inpatient...

Estimated: $74,000 - $100,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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