- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... and AHS and Behavioral Health Department of Alameda County Utilization Plan. 2. Collaborates with the treatment team...identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management … more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... adapting to ad hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care. DUTIES & ESSENTIAL JOB… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …experienced **MD** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their specialization in ... **Workforce Classification:** Telecommuter **Join Our Team : Do Meaningful Work and Improve People's Lives**...guidelines, and member contracts. In addition, they will support clinical programs (disease and case management ), as… more
- Merck & Co. (Rahway, NJ)
- …, Clinical Supply Chain Management , Clinical Trial Management , Clinical Trials, Cross-Functional Team Leadership, Data Analysis, Demand Planning, ... development, regulatory, quality and other supply chain areas to address clinical supply and/or change management related topics. Responsible and accountable… more
- Stanford Health Care (Palo Alto, CA)
- …trends within health care and academic medical centers that may impact product/service utilization or Value Based Management processes. + Collaborate with key ... patient safety, innovation, and research excellence. Join a multidisciplinary team where your expertise ensures rigorous protocol implementation and high-quality… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …appropriate procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy ... is a senior member of the Medical Policy and Clinical Coding team whose work is critical...and diagnosis codes for company medical policies and UM ( Utilization Management ) guidelines that reflect medical necessity,… more
- BeOne Medicines (Emeryville, CA)
- …readiness quality, within agreed timelines and budget + Leads the regional clinical operations team (including oversight of external partners working on ... of the job:** **Regional Leadership** + Leads the regional clinical operations team effectively, ensures effective decision...updates on study progress in the region to senior management and Global Clinical Study Manager as… more
- Monte Nido (White Plains, NY)
- …expertise and experience real life challenges. We are seeking a **Eating Disorder Clinical Director** to join the **Monte Nido** team . The **Mental Health ... opportunity for people to realize their healthy selves. **Eating Disorder Clinical Director** **Monte Nido Eating Disorder Center of Westchester** **White Plains,… more
- Battelle Memorial Institute (Arlington, VA)
- …Research and Analytics (HRA) business line is seeking a highly motivated, full-time **Licensed Clinical Social Worker (LCSW)** to join our team in support of our ... families, ensuring comprehensive support for those who serve. As a Licensed Clinical Social Worker (LCSW), you will contribute to impactful research and analytics… more
- Oregon State University (Portland, OR)
- …Department Pharmacy Professnl Instr (PHR) Position Title Assistant/Associate Professor ( Clinical ) Job Title Assistant/Associate Professor ( Clinical ) Appointment ... a full-time (1.00 FTE ), 12-month, fixed-term, Assistant or Associate Professor ( Clinical ) position. Reappointment is at the discretion of the Department Head.… more
- CSL Behring (Waltham, MA)
- …to meet project requirements. Project and Resource Management Work with Clinical Bioanalytics and Biomarker leadership team to execute robust insourcing ... and a focus on collaboration, we're building a future-ready team that thrives in dynamic biotech ecosystems. Joining CSL...difference worldwide. Could you be our next AD of Clinical Assay? The job is in our Waltham MA… more
- Teleflex (San Francisco, CA)
- … application of Vascular Access products. + Work in conjunction with sales/ clinical representatives, management , and executive leadership to properly identify ... credentials, where applicable + Provide written and verbal communication to sales/ clinical representatives, management , and executive leadership regarding field… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …of a core team . You'll collaborate cross-functionally with care management , utilization management , provider/member relations, and market-facing teams ... **Workforce Classification:** Hybrid **Join Our Team : Do Meaningful Work and Improve People's Lives** Our purpose, to improve customers' lives by making healthcare… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …tools, forms, order sets, rules, reports and other new functionalities. The Clinical Informaticist will collaborate with other team members to ensure ... care that is personal, convenient and empowering. Our scientists will work with clinical experts to take laboratory discoveries and create treatments that are a… more
- ERP International (Luke AFB, AZ)
- …algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with ... Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health Services… more
- Luke Staffing (Yigo, GU)
- …peers, and other health team members. + Submits all concerns through Utilization Management Director; be able to identify, analyze, and make recommendations ... (BLS) + **Experience:** Possess a minimum of 2-years of clinical nursing experience is required. One year of previous...experience is required. One year of previous experience in Utilization Management is required. Full time employment… more
- Stanford Health Care (Palo Alto, CA)
- …external review agencies' requirements. Case Managers act as consultants to the clinical team , service lines, and other departments regarding patient assessment ... team members; arranges followup care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all inpatients for… more
