• Care Review Clinician

    Molina Healthcare (Lexington, KY)
    ** CARE REVIEW CLINICIAN INPATIENT ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and ... this position we are seeking a Registered Nurse with previous Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines._** **_STATE… more
    Molina Healthcare (10/17/24)
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  • Care Review Clinician

    Molina Healthcare (Richmond, KY)
    …we are seeking a (RN) Registered Nurse with previous experience in Hospital 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 (10/31/24)
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  • Care Review Clinician

    Molina Healthcare (Milwaukee, WI)
    …we are seeking a (RN) Registered Nurse with previous experience in Hospital 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 (10/09/24)
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  • Care Review Clinician , Prior…

    Molina Healthcare (Las Vegas, NV)
    …we are seeking a (RN) Registered Nurse with previous experience in Hospital 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 (10/09/24)
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  • Care Review Clinician

    Molina Healthcare (Madison, WI)
    …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 (10/18/24)
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  • Care Review Clinician , PA…

    Molina Healthcare (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
    Molina Healthcare (10/24/24)
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  • Nurse Clinician : Prior Authorization:…

    Molina Healthcare (Temecula, CA)
    **_JOB TITLE: CARE REVIEW CLINICIAN , PRIOR AUTHORIZATION (REGISTERED NURSE, OR LVN)_** **For this position we are seeking a Nurse with previous experience in ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3… more
    Molina Healthcare (10/17/24)
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  • Behavioral Health Clinician (Utilization…

    Molina Healthcare (Bowling Green, KY)
    …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines._** **_STATE OF… more
    Molina Healthcare (10/12/24)
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  • Utilization Review Nurse

    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 (10/18/24)
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  • Utilization Review Nurse

    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
    US Tech Solutions (10/18/24)
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  • Clinical Appeals, RN, Remote

    RWJBarnabas Health (Oceanport, NJ)
    …have proficiency with online nationally recognized UM criteria, including Milliman Care Guidelines (MCG) and/or InterQual (IQ). + Review patient medical ... the last 2 years in a facility environment + Minimum of 2 years UR/ UM /CM Preferred: + Medical-surgical/critical care experience Other Duties: Please note this… more
    RWJBarnabas Health (10/30/24)
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  • Utilization Management Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …Qualifications** **PURPOSE:** Supervise the daily operations of the utilization management ( UM ) department functions to ensure appropriate coordination of health ... care services and compliance with UR policies/procedures, as well...We are looking for an experienced people leader and clinician in the greater Baltimore metropolitan area who is… more
    CareFirst (10/17/24)
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  • Advanced Practice Professional (PA) General…

    University of Michigan (Ann Arbor, MI)
    …patients, populations and communities through excellence in education, patient care , community service, research and technology development, and through leadership ... guided by our Strategic Principles and has three critical components; patient care , education and research that together enhance our contribution to society. **Why… more
    University of Michigan (10/30/24)
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  • Quality Management Nurse Consultant

    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
    US Tech Solutions (10/18/24)
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  • Assistant or Associate Professor of Clinical…

    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 (10/16/24)
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  • Manager, Research Laboratory

    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
    University of Miami (10/01/24)
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  • Psychometrist

    University of Michigan (Ann Arbor, MI)
    …an as needed basis + Participation in case reviews with the supervising clinician may also be required + Provide training to psychometrists, students and ... Deadline** Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting.… more
    University of Michigan (10/23/24)
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