- Molina Healthcare (Sparks, NV)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... Essential Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program activities… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …promote and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * MEETINGS - Attend ... improve quality * ROLE MODEL - Act as a clinical resource and role model for department personnel *...required to perform on-call duties * Tuberculosis testing is completed upon hire and additionally as required Department: Clinical … more
- Campbell County Health (Gillette, WY)
- …inpatients, outpatients, and contracted patients, under the supervision of the Rehab Supervisor and Director of Rehab. The ST develops and implements individualized, ... in patient record that which reflects skilled treatment, time billed and accurate utilization of CPT codes Develops an age-appropriate plan of care which addresses… more
- UTMB Health (Webster, TX)
- …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... Technologist assists Pharmacists in providing drug distribution, technical services, and clinical services associated with the preparation, storage and dispensing of… more
- VitalCore Health Strategies (Muskegon, MI)
- …positive, professional, and collaborative relationships with clients (administrator/warden, supervisor , etc.) and ensuring customer satisfaction. HEALTH SERVICES ... administration/related field. Licensed Registered Nurse. Minimum of two (2) years of management experience in a healthcare setting necessary. Subject to initial and… more
- Martin's Point Health Care (Portland, ME)
- …Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, ... + 3+ years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting + Leadership and/or … more
- CareFirst (Baltimore, MD)
- …programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Utilization Management **Equal Employment ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- Point32Health (Canton, MA)
- …. **Job Summary** Under the direction of the Pharmacy Utilization Management (UM) Supervisor , the Clinical Pharmacist is responsible for ... authorization (PA) requests for coverage determinations (CD), and exceptions. The Clinical Pharmacist ensures timely disposition of reviews for CD and exceptions… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in department) - Provides guidance and leadership to the daily activities of the Utilization Management Department clinical staff. Acts as resource to ... staff, members and providers. + Provides backup for the Supervisor , whenever necessary. Participates in the orientation of new...Bachelors degree preferred. + Minimum of three years of clinical experience required. Utilization Management … more
- Covenant Health Inc. (Knoxville, TN)
- …audits thus promoting a culture of professional expertise in utilization management . + Provides monitoring and oversight of non- clinical utilization ... Overview Registered Nurse Utilization Management Full Time, 80 Hours...and written communication skills in order to clearly present clinical and financial data to various audiences as necessary.… more
- Saint Francis Health System (Tulsa, OK)
- …notification and performing Nonclinical roles .** Job Summary: Provides administrative and clinical support to the hospital and treatment team throughout the review ... in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal… more
- Catholic Health (Buffalo, NY)
- …Clinical Documentation Integrity. The Middle Revenue Cycle - Clinical Supervisor is responsible for training and mentoring Utilization Review, Clinical ... coverage as needed Summary: The Middle Revenue Cycle - Clinical Supervisor , as an active member of...one of the major consultant firms + Proficiency in utilization management / clinical documentation Integrity and… more
- Helio Health Inc. (Syracuse, NY)
- …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
- University of Rochester (Rochester, NY)
- …Staff Pharmacist - Clinical Responsibilities_** + In coordination with the clinical pharmacy team, oversees the management of drug shortages in the ... conduct the business of the functional unit under their supervision and management . Their supervisor should be aware of all ongoing interdepartmental… more
- BayCare Health System (Tampa, FL)
- …built on a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities ... + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St Josephs | Clinical |… more
- WMCHealth (Valhalla, NY)
- Supervisor Of Nursing - Clinical Care Management Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management ... Details: N4 Supervisor of Nursing/Nurse Manager - Clinical Care Management Internal Posting: 12/03/25 to...the procedures specified in the Clinical Care Management Department through review of the Utilization … more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title:** **Social Worker - Emergency Dept (High Utilization )** **_Social Work Services at the Mount Sinai Hospital_** The Mount Sinai ... repeat ED visits and limited access to community-based care. + Excellent clinical skills, with exceptional skills in rapid psychosocial assessment and focused… more
- University of Southern California (Arcadia, CA)
- …of the RN staff, and assists the Director and/or Manager with the operational management of the nursing unit. The Supervisor coordinates care of the patients ... of resources so that patient outcomes are optimized. The Supervisor serves as a professional clinical role...operations of assigned areas (budget, regulatory compliance, and resource utilization ). + Demonstrates clinical performance in the… more
- Children's Home Healthcare (Amarillo, TX)
- …A VALID RN LICENSE* Children's Home Healthcare is now hiring for an RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in Pediatric Home ... this growing professional team! We are seeking an experienced Clinical Supervisor in the Amarillo area. The...skills and willing to travel to patient homes + Utilization Management Experience + Reliable transportation for… more
- Boston University (Boston, MA)
- **FLOATING CLINICAL CARE SUPERVISOR , School of Dental Medicine, Clinical Affairs** **Job Description** **FLOATING CLINICAL CARE SUPERVISOR , School of ... compensation at the time of posting. **Position Type** Full-Time/Regular The Floating Clinical Care Supervisor is responsible to manage, provide guidance and… more
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