- Covenant Health Inc. (Louisville, TN)
- Overview Utilization Review Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest ... from ongoing review or retrospective utilization data. + Monitors current utilization review criteria and length of stay norms. + Assists with education… more
- Centene Corporation (Tallahassee, FL)
- …must reside in Florida._** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and ... utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with...BH utilization management + Works with BH utilization management team and senior management to… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000082 Date: Feb 26, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 843801 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000082 Pay Plan:… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... and risk assessments. Develops treatment plans with oversight from senior clinicians. Collaborates with interdisciplinary teams on care coordination. Provides… more
- CVS Health (Portland, OR)
- …care: + Meet with customers to present Omnicare Nursing Services and promote utilization of support tools and programs + Evaluate regulatory compliance and determine ... clinical education needs for SNF/ Senior Living customers as it relates to pharmacy services...Living customers as it relates to pharmacy services + Review medication carts and medication rooms for proper medication… more
- Sunrise Senior Living (Edison, NJ)
- **When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will ... and shed light on meaningful ways to serve, grow, and shine together.** **Sunrise Senior Living was again certified as a Great Place to Work(R) by Activated… more
- Geisinger (Danville, PA)
- …teams assistance with nursing skill mix optimization. + Assist in review of ambulatory nursing position justifications to ensure appropriate scope assignment. ... staff and members of other departments, effective communications, appropriate resource utilization and sound planning skills. + Communicates pertinent information as… more
- Magellan Health Services (Albuquerque, NM)
- …to an assigned interdisciplinary UM team. + Responsible for the quality of utilization review determinations, including appeals. + Reviews cases, makes medical ... is a remote in New Mexico. Candidates must be licensed and reside in NM. This position supports the...effectiveness and cost of care of clinical programs through review and analysis of utilization and financial… more
- City and County of San Francisco (San Francisco, CA)
- …permanent 2932 positions + All City departments with open permanent positions can review your application Under direction, the 2932 Senior Behavioral Health ... Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health...the California Board of Behavioral Sciences (BBS) for + Licensed Clinical Social Worker (LCSW) OR + Licensed… more
- Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
- …social work degree meets the accreditation standards for a masters of social work. Licensure. Senior social workers must be licensed or certified by a state at ... to other PACT Social Workers, mentor staff to ensure utilization of the PACT model by assessing the social... Senior Social Worker Licensure/Certification. Individuals assigned as Senior Social Workers must be licensed or… more
- North Wind Group (Huntsville, AL)
- Location: Huntsville/Auburn/Birmingham, AL or Nashville, TN Title: Civil Senior Project Manager Schedule (FT/PT): FT Travel Required: As needed "Large Firm ... throughout the Southeast region. POSITION PURPOSE: A Project Manager (PM) is an experienced licensed engineer who can define a project, develop a set of tasks to… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review /Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/Quality Assurance experience. Experience in the… more
- MyFlorida (Daytona Beach, FL)
- SENIOR COMMUNITY HEALTH NURSE - 64085425 Date: Mar 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 847869 Agency: Department of Health Working Title: SENIOR COMMUNITY HEALTH NURSE - 64085425 Pay Plan: Career...issues and complaints within the clinic. . Utilize chart review tool to Assist ADON with charts reviews. Assists… more
- PruittHealth (Savannah, GA)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... clinical operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… more
- Sharp HealthCare (San Diego, CA)
- …practices. **Summary** Seeking a detail-oriented (preferably experienced) Regulatory Affairs Senior Specialist to join our regulatory dept. Responsible for ensuring ... interpreting and presenting clinical quality-related data + Previous case review experience **Preferred Qualifications** + Master's Degree In related field.… more
- Prime Therapeutics (Columbus, OH)
- … functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- AECOM (Glen Allen, VA)
- …better world. Join us. **Job Description** **AECOM** is currently seeking a ** Senior Electrical Engineer** to support commissioning programs throughout the US and ... OCONUS regions. This is an onsite position. The Senior Electrical Engineer will be responsible for leading and managing technical assignments and ensuring the… more
- Grant Thornton (Philadelphia, PA)
- As the Corporate Tax Senior Manager, you'll be a member of our Corporate Tax Solutions Family and work on business income tax planning, corporate compliance, and ASC ... all with the resources, environment, and support to help you excel. Success in the Senior Manager role is the primary pathway to Partner or Managing Director in our… more
- Pfizer (Austin, TX)
- …to bring therapies to patients that significantly improve their lives. The Senior Healthcare Rep is responsible for launching new products, deciding upon best ... formulary access, and engaging in product promotion within assigned accounts. The Senior Healthcare In addition, the rep is charged with sales efforts and… more
- Colliers Engineering & Design (Holmdel, NJ)
- Overview Colliers Engineering & Design is seeking a Senior Project Manager for our Holmdel, NJ office! This Senior Project Manager will lead multidisciplinary ... a client's satisfaction and firm's expectations in terms of resource utilization and profitability. Actively manages client budgets, schedules, programs, project… more
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