15,303 Director of Network Management Jobs Nationwide

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Clinical leadership within Optum Serve and reports to the Chief Medical Officer, Community Care Services. They collaborate with the CEO, Community...

* Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD...

* Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical...

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Clinical leadership within Optum Serve and reports to the Chief Medical Officer, Community Care Services. They collaborate with the CEO, Community...

* Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values...

* Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided...