7303 management representative jobs found

Utilization Management Representative I L ocation: Midland GA, Atlanta GA Responsible for coordinating cases for precertification and prior authorization review. Primary duties may include, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains positive customer relations and coordinates with various...

Description Utilization Management Representative I L ocation: Midland GA, Atlanta GA Responsible for coordinating cases for precertification and prior authorization review. Primary Duties May Include, But Are Not Limited Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains positive customer relations and...

Description Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year. This is a 24 hour call center, open 365 days, with varied 1st, 2nd, and 3rd shifts to include weekends. Training is Monday-Friday 10a-6p EST. How You Will Make An Impact Manage incoming calls Provide in the moment support Make referrals in the community Obtain intake (demographic) information from caller...

Description Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year. This is a 24 hour call center, open 365 days, with varied 1st, 2nd, and 3rd shifts to include weekends. Training is Monday-Friday 10a-6p EST. How You Will Make An Impact Manage incoming calls Provide in the moment support Make referrals in the community Obtain intake (demographic) information from caller...

Description Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year. This is a 24 hour call center, open 365 days, with varied 1st, 2nd, and 3rd shifts to include weekends. Training is Monday-Friday 10a-6p EST. How You Will Make An Impact Manage incoming calls Provide in the moment support Make referrals in the community Obtain intake (demographic) information from caller...

Job Family: Customer Care Type: Full time Date Posted:Nov 18, 2022 Req #: JR38463 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint PA, Seven Fields VA, Arlington MA, Boston IN, Indianapolis OH, Cincinnati NY, New York CT, Rocky Hill LA, Baton Rouge MI, Wixom DC, Washington NV, Las Vegas MN, Mendota Heights VA, Alexandria TN, Knoxville MO, Columbia VA, Ashburn NC, Cary WA, Lakewood CA, Rancho Cordova WV, Charleston NE, Lincoln DE, Wilmington MA, Boston NE, Omaha OH, Seven Hills RI, Smithfield NC, Winston GA, Atlanta IL, Deerfield VA, Richmond KS, Topeka VA, Roanoke NY, Lake Success CA, Cerritos FL, Jacksonville CA, Woodland Hills WI, Waukesha NJ, Morristown OH, Mason CA, Glendale CA, Walnut Creek PA, Hermitage KY, Louisville WA, Seattle NH, Manchester TX, Grand Prairie IL, Chicago TX, Austin SC, Columbia...

Job Family: Customer Care Type: Full time Date Posted:Jan 03, 2023 Req #: JR44276 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Crisis Management Representative - SPANISH Speaking Remote 2nd Shift 4 pm - 12:30 am, Thursday - Monday Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year....

Job Family: Customer Care Type: Full time Date Posted:Jan 03, 2023 Req #: JR44276 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Crisis Management Representative - SPANISH Speaking Remote 2nd Shift 4 pm - 12:30 am, Thursday - Monday Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year....

Description Utilization Management Representative Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Elevance Health family of companies. As a Utilization Management Representative, you will be responsible for managing incoming calls, including triage, opening of cases, and authorizing sessions. How You Will Make An Impact Manage incoming calls or post services claims work Determine contract and benefit eligibility Provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests Obtain intake (demographic) information from caller Conduct a thorough radius search in Provider Finder...

Description Utilization Management Representative Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Elevance Health family of companies. As a Utilization Management Representative, you will be responsible for managing incoming calls, including triage, opening of cases, and authorizing sessions. How You Will Make An Impact Manage incoming calls or post services claims work Determine contract and benefit eligibility Provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests Obtain intake (demographic) information from caller Conduct a thorough radius search in Provider Finder...

Job Family: Customer Care Type: Full time Date Posted:Nov 18, 2022 Req #: JR38463 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint PA, Seven Fields VA, Arlington MA, Boston IN, Indianapolis OH, Cincinnati NY, New York CT, Rocky Hill LA, Baton Rouge MI, Wixom DC, Washington NV, Las Vegas MN, Mendota Heights VA, Alexandria TN, Knoxville MO, Columbia VA, Ashburn NC, Cary WA, Lakewood CA, Rancho Cordova WV, Charleston NE, Lincoln DE, Wilmington MA, Boston NE, Omaha OH, Seven Hills RI, Smithfield NC, Winston GA, Atlanta IL, Deerfield VA, Richmond KS, Topeka VA, Roanoke NY, Lake Success CA, Cerritos FL, Jacksonville CA, Woodland Hills WI, Waukesha NJ, Morristown OH, Mason CA, Glendale CA, Walnut Creek PA, Hermitage KY, Louisville WA, Seattle NH, Manchester TX, Grand Prairie IL, Chicago TX, Austin SC, Columbia...

Job Family: Customer Care Type: Full time Date Posted:Jan 03, 2023 Req #: JR44276 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Crisis Management Representative - SPANISH Speaking Remote 2nd Shift 4 pm - 12:30 am, Thursday - Monday Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year....

Job Family: Customer Care Type: Full time Date Posted:Jan 03, 2023 Req #: JR44276 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Crisis Management Representative - SPANISH Speaking Remote 2nd Shift 4 pm - 12:30 am, Thursday - Monday Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. As a Crisis Management Representative, you will be responding to phone calls with people who are in a crisis, offering both in the moment support through connections to a licensed crisis counselor or a referral in the community. This is a nationwide network. We operate 24 hours a day, 7 days a week, 365 days out of the year....

Job Family: Customer Care Type: Full time Date Posted:Jun 17, 2022 Req #: JR86 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Utilization Management Rep III Remote - Anywhere in the US; This is a 24/7/365 crisis center operation with varied 1st, 2nd, and 3rd shifts to include weekends. Training is full time Monday - Friday 10 am - 6 pm EST/9 am - 5 pm CST $500 Sign On Bonus Offered* Be part of an extraordinary teamWe are looking for leaders at all levels of the organization who are passionate about making an impact on our members and thecommunities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purposeand an evolving, high-performance culture that empowers you to make an impact? Build the Possibilities. Make an extraordinary impact....

Job Family: Customer Care Type: Full time Date Posted:Jun 17, 2022 Req #: JR86 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Utilization Management Rep III Remote - Anywhere in the US; This is a 24/7/365 crisis center operation with varied 1st, 2nd, and 3rd shifts to include weekends. Training is full time Monday - Friday 10 am - 6 pm EST/9 am - 5 pm CST $500 Sign On Bonus Offered* Be part of an extraordinary teamWe are looking for leaders at all levels of the organization who are passionate about making an impact on our members and thecommunities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purposeand an evolving, high-performance culture that empowers you to make an impact? Build the Possibilities. Make an extraordinary impact....

Job Family: Customer Care Type: Full time Date Posted:Jun 17, 2022 Req #: JR86 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Utilization Management Rep III Remote - Anywhere in the US; This is a 24/7/365 crisis center operation with varied 1st, 2nd, and 3rd shifts to include weekends. Training is full time Monday - Friday 10 am - 6 pm EST/9 am - 5 pm CST $500 Sign On Bonus Offered* Be part of an extraordinary teamWe are looking for leaders at all levels of the organization who are passionate about making an impact on our members and thecommunities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purposeand an evolving, high-performance culture that empowers you to make an impact? Build the Possibilities. Make an extraordinary impact....

Job Family: Customer Care Type: Full time Date Posted:Jun 17, 2022 Req #: JR86 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Utilization Management Rep III Remote - Anywhere in the US; This is a 24/7/365 crisis center operation with varied 1st, 2nd, and 3rd shifts to include weekends. Training is full time Monday - Friday 10 am - 6 pm EST/9 am - 5 pm CST $500 Sign On Bonus Offered* Be part of an extraordinary teamWe are looking for leaders at all levels of the organization who are passionate about making an impact on our members and thecommunities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purposeand an evolving, high-performance culture that empowers you to make an impact? Build the Possibilities. Make an extraordinary impact....

Description Utilization Management Representative I Location: Tampa, FL (Remote) Here’s What a Typical Day May Look Like Responsible for coordinating cases for precertification and prior authorization review. Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains...

Description Utilization Management Representative I Location: Tampa, FL (Remote) Here’s What a Typical Day May Look Like Responsible for coordinating cases for precertification and prior authorization review. Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains...

Our client, a major healthcare industry leader, is looking for Case Management Representatives for Remote positions. All candidates my have prior healthcare call center exprience. Pelease ensure that all contact information is update and correct with the best phone number for me to reach you at. Thank you,  salary: $17.87 - $17.88 per hour shift: First work hours: 8 AM - 5 PM education: High` School Responsibilities Communicates with all levels of staff, matrix partners, and customers This role supports our clinical teams by completing an assessment that is used to stratify Cigna MA customers’ risk level. This is a National Position for Medicare Advantage Works independently with minimal direction Applies knowledge of CIGNA  Medicare services Operates well in a team environment; contributes to the Case Management team and organization’s goals Manages to productivity standards The essential functions of this role include: working up to 5 hrs of overtime per week...

Our client, a major healthcare industry leader, is looking for Case Management Representatives for Remote positions. All candidates my have prior healthcare call center exprience. Pelease ensure that all contact information is update and correct with the best phone number for me to reach you at. Thank you,  salary: $17.87 - $17.88 per hour shift: First work hours: 8 AM - 5 PM education: High` School Responsibilities Communicates with all levels of staff, matrix partners, and customers This role supports our clinical teams by completing an assessment that is used to stratify Cigna MA customers’ risk level. This is a National Position for Medicare Advantage Works independently with minimal direction Applies knowledge of CIGNA  Medicare services Operates well in a team environment; contributes to the Case Management team and organization’s goals Manages to productivity standards The essential functions of this role include: working up to 5 hrs of overtime per week...

Description Responsible for coordinating cases for precertification and prior authorization review. Primary Duties May Includes, But Are Not Limited Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are...

3.6 Full-time Full Job Description Job Family: Customer Care Type: Full time Date Posted: Dec 14, 2022 Req #: JR26502 Description Responsible for coordinating cases for precertification and prior authorization review. Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains positive...

Job Family: Customer Care Type: Full time Date Posted:Jan 04, 2023 Req #: JR38905 Location: NY, Latham GA, Atlanta National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint MO, St. Louis Description Responsible for coordinating cases for precertification and prior authorization review. Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes...