- Cambia Health Solutions, Inc (Renton, WA)
- …the Utilization Management team, our Associate Medical Director Behavioral Health and UM Medical Directors provides leadership, and clinical oversight for ... Associate Medical Director Behavioral Health or UM Medical DirectorWork from home within Oregon, Washington,... opinions about medical conditions, procedures, and treatments under review .At least 3 years clinical experience.Two years… more
- University of Maryland Medical System (Baltimore, MD)
- …in the nation. Patients and professionals alike appreciate the unique advantages offered here at UM Rehab & Ortho Institute. As a Registered Nurse at UM Rehab & ... roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a...Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member… more
- University of Maryland Medical System (Baltimore, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... Senior Registered Nurses to join our CMR Team at UM Rehab & Ortho Institute. This role is designed...role is designed for the nurse who is a clinical and professional leader at the unit level. Demonstrates… more
- University of Maryland Medical System (Baltimore, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... among many others. Job Description General Summary Supports excellence in clinical practice and patient care quality through the implementation and evaluation… more
- University of Maryland Medical System (Catonsville, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... role is designed for the nurse who is a clinical and professional leader at the unit level. Demonstrates...ancillary personnel's skills and development; leads unit based peer review processes. Actively engaged in advancing own practice; role… more
- University of Maryland Medical System (Baltimore, MD)
- … for a professional journal (minimum of 2/year, submit signed "Peer Reviewer Validation Form")Demonstrated ability to assume a clinical leadership role. ... steroid-free protocol and pancreas/kidney transplant. From our National Cancer Institute-designated UM Marlene and Stewart Greenebaum Cancer Center to The University… more
- University of Maryland Medical System (Baltimore, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... in the nation. Patients and professionals alike appreciate the unique advantages offered here at UM Rehab & Ortho Institute. As a Registered Nurse at UM Rehab &… more
- University of Maryland Medical System (Baltimore, MD)
- …steroid-free protocol and pancreas/kidney transplant. From our National Cancer Institute-designated UM Marlene and Stewart Greenebaum Cancer Center to The University ... Charter. Independently provides and coordinates care provided to patients within a clinical specialty. Serves as a fully effective and participative member of the… more
- NorthBay Health (Fairfield, CA)
- …Management and Population Health which includes: Utilization Management, Utilization Review , Inpatient, Outpatient and Complex Case Management, Discharge Planning, ... cost effective and quality patient outcomes through the supervision of clinical /professional staff, collaboration with medical staff, nursing, and support staff.… more
- University of Maryland Medical System (La Plata, MD)
- Company Description At University of Maryland Charles Regional Medical Center ( UM CRMC), our talented and diverse groups of professionals represent our strength. ... supportive and stimulating environment. Job Description Under the supervision of the Clinical Manager, is responsible for the coordination of clinical activities… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, August 5, 2024 Centers Plan for Healthy Living's goal is to create the ... applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help… more
- Molina Healthcare (Long Beach, CA)
- …Care setting + 5+ years of clinical correspondence processing and quality review experience + **Bilingual- Spanish** + ** UM experience** To all current ... **Job Description** **Job Summary** The Clinical Correspondence Review Nurse is responsible...are seeking a candidate with a RN license and UM experience. Prior Case Management experience highly preferred. Strong… more
- AmeriHealth Caritas (Charlotte, NC)
- …information necessary to perform a thorough medical necessity review . It is within Clinical Care Reviewer UM discretion to pend requests for additional ... on a 24/7, 365 basis. Under the direction of the supervisor, the Clinical Care Reviewer UM is responsible for completing medical necessity reviews. Using … more
- Integra Partners (Troy, MI)
- …and clinical processes + Develop and deliver comprehensive training programs for UM clinical staff on: + Writing clear and concise clinical ... educator to join our Operations Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management ( UM ) processes. The… more
- Healthfirst (NY)
- …approvals from key governance committee members. + Review the appropriate UM or related clinical and medical policies, job aids/procedures, and ... spearhead the policy work that will inform Medical and Clinical strategy + Perform editorial formatting and review...ad hoc medical condition research per Medical Director and/or UM Clinical Director requests. + Collaborate with… more
- Kepro (AR)
- …deliverables and provide day-to-day oversight to manage multiple areas of the UM program and oversee the implementation of clinical contract requirements ... Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver… more
- The Cigna Group (Franklin, TN)
- … clinical compliance within the UM programs, including matters concerning clinical policy, quality management (QM), program development, review of UM ... **Responsibilities and Essential Functions** + Responsible for development of clinical policy, clinical review decisions,...Client teams for clinical matters related to UM client contracts + Review official program… more
- University of Miami (Miami, FL)
- …and Clinical Information Services (LRCIS) The University of Miami ( UM ) Libraries seeks nominations and applications for a creative, innovative professional to ... and Information Services Librarian of the Department of Learning, Research, and Clinical Information Services (LRCIS) on UM 's Medical Campus. Under the… more
- AmeriHealth Caritas (Dublin, OH)
- …information necessary to perform a thorough medical necessity review . It is within Clinical Care Reviewer UM discretion to pend requests for additional ... **RN Clinical Care Reviewer , Concurrent Review ,...365 basis. Under the direction of the supervisor, the Clinical Care Reviewer UM is responsible… more
- University of Miami (Coral Gables, FL)
- …serves the Miller School of Medicine's educational and biomedical research programs, and UM 's clinical enterprise, UHealth. Library services are also provided 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) . The University of… more