- Community Health Plan of Washington (Eugene, OR)
- …an equitable work environment. About the Role The Level I Utilization Management Clinician performs utilization review for medical or behavioral health requests ... Care , preferred. Essential functions and Roles and Responsibilities: * Conduct review of hospital notification or prior authorization care requests against… more
- Molina Healthcare (New York, NY)
- …people who are eligible for Medicaid .** **We are looking for a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
- Molina Healthcare (Long Beach, CA)
- **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE** **For this position we are seeking a (RN) Registered Nurse with previous ... experience in Acute Care , Concurrent Review / Utilization Review ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Molina Healthcare (SC)
- **_JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW BEHAVIORAL HEALTH : REGISTERED NURSE (2 openings)_** **_For this position we are seeking a (RN) ... Registered Nurse with previous experience in Behavioral Health Acute Care , Concurrent Review / Utilization Review ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Molina Healthcare (Amarillo, TX)
- … Care Model * Adhere to UM policies and procedures * Mentor New Care Review Clinicians during orientation period *Sign off on core competencies for new ... Care Review Clinicians during peer mentoring phase *Model New programs, techniques and trainings with peers. **Job Qualifications** **Required Education**… more
- Molina Healthcare (KY)
- …position we are seeking a (RN) Registered Nurse with previous experience in Acute Care , Concurrent Review / Utilization Review / Utilization Management and ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (TX)
- …position we are seeking a (RN) Registered Nurse with previous experience in Acute Care , Concurrent Review / Utilization Review / Utilization Management and ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (Long Beach, CA)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... shift from then on._** **_Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is… more
- Molina Healthcare (Fredericksburg, VA)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Molina Healthcare (Louisville, KY)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Molina Healthcare (Lexington, KY)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- US Tech Solutions (Chicago, IL)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. +… more
- US Tech Solutions (May, OK)
- …. MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. .… more
- University of Michigan (Ann Arbor, MI)
- …bill directly for their services, and must have a certified clinician countersign all patient encounter notes. **Responsibilities **Clinical Experience:** + Each ... resident will shadow a UMOPC clinician as he/she attends to his/her various roles. As...coordinate rehabilitation activities with medical staff and other health care disciplines **Research Experience:** + Each resident is required… more
- Kepro (Indianapolis, IN)
- …Examiners in the State of Indiana, Michigan, or Illinois + Utilization Management ( UM ) review experience + Experience as a physician executive with significant ... accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization...A strong knowledge of Quality Assurance (QA) and Utilization Review (UR) + A contemporary clinician who… more
- University of Michigan (Ann Arbor, MI)
- …and wellness care to University of Michigan students, as well as primary care services for eligible UM faculty and staff. UHS is actively seeing ... UHS. MAs are frontline in providing the highest quality care for students and other UM affiliated...families according to the teaching plan established by a clinician **Required Qualifications + High school diploma or GED… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) The Case Manager is accountable to facilitate the interdisciplinary team to ... plan, coordinate, implement and evaluate patient care for assigned service line across the...community, patient/significant others/family and payers by functioning as a clinician , consultant, advocate and educator for assigned service.The Case… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- University of Miami (Miami, FL)
- …pediatrics units, students and residents are active participants in our multidisciplinary care . Our faculty are highly dedicated clinician educators committed to ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Academic Pediatric Hospitalist… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . This ... procedures, and that technical/research personnel is informed of and comply with UM fiscal and personnel policies and procedures; maintains appropriate files and… more