• Staff Utilization Management

    Humana (Trenton, NJ)
    …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
    Humana (12/04/25)
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  • Utilization Management Nurse

    US Tech Solutions (Hopewell, NJ)
    …case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and ... duties and types of care management as assigned by management .** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines… more
    US Tech Solutions (10/24/25)
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  • Clinical Reviewer, Nurse

    Evolent (Trenton, NJ)
    …a Clinical Reviewer, Nurse, you will routinely interact with leadership and management staff , other CR's ( Clinical Reviewers), providers, office staff ... Nurse, you will be a key member of the utilization management team. We can offer you...standards in the participating provider network and for other clinical staff . + Converses with medical office… more
    Evolent (12/10/25)
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  • Clinical Supply Chain Liaison- Chester…

    Penn Medicine (West Chester, PA)
    …to systemwide Value Analysis Councils. Acting as a liaison among Materials Management , Physicians, Clinical Groups, Supply Chain, and System Leadership, the ... Services at all levels, Director of Supply Chain, Finance, Corporate Purchasing, Clinical Engineering, and Materials Management , and all relevant departments in… more
    Penn Medicine (12/04/25)
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  • Associate Clinical Manager Ambulatory RN…

    Penn Medicine (Philadelphia, PA)
    …EHR optimization. They will assist with hiring onboarding and orientation of new clinical staff , complete clinical competencies and evaluations. The ... will assist with hiring onboarding and orientation of new clinical staff , complete clinical competencies...utilization + Assists with the implementation of change management strategies within the practice in alignment with department,… more
    Penn Medicine (09/27/25)
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  • Clinical or Application Analyst (Associate,…

    Penn Medicine (Philadelphia, PA)
    …data. Assists/Trains internal team members, physicians, clinical and practice staff in the utilization of functionality within the application. Promptly ... COMMUNICATION: Ability to communicate effectively with all levels of staff PROJECT/CHANGE MANAGEMENT : Ability to implement process...management tools and query language - preferred Senior Clinical Analyst A Senior Clinical Analyst may… more
    Penn Medicine (11/04/25)
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  • Clinical Informatics Specialist

    Penn Medicine (West Chester, PA)
    staff , HR and nursing staff development to ensure the smooth onboarding of clinical staff . * Trains providers, nurses and other clinical staff on ... during business hours. * Participates in rotating on-call 24/7 telephone support for clinical staff , for issues immediately impacting patient care * Provides… more
    Penn Medicine (12/04/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Philadelphia, PA)
    …plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education ... clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG… more
    Deloitte (11/21/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Wilmington, DE)
    …courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional ... eligibility for treatment. + Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : + Participates… more
    Fresenius Medical Center (11/12/25)
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  • Field Medical Director, Pain Management

    Evolent (Trenton, NJ)
    … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
    Evolent (11/19/25)
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  • Clinical Care Manager

    Penn Medicine (Bala Cynwyd, PA)
    …medical service utilization . + Collaborates with physician and practice staff in identifying appropriate patients for care management utilizing established ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
    Penn Medicine (11/21/25)
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  • Assistant Director of Clinical Health…

    Thomas Edison State University (Trenton, NJ)
    …placement. - Monitor all students' clinical hours. - Maintain accurate records of clinical site utilization . - Enter student clinical data into various ... databases. - Maintain a collaborative, positive relationship with clinical agency staff ; - Mentor and evaluate clinical instructors in clinical settings… more
    Thomas Edison State University (12/10/25)
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  • Clinical Director

    Monte Nido (Villanova, PA)
    …providing the opportunity for people to realize their healthy selves. ** Clinical Director** **EDC - Pennsylvania** **Villanova, PA** **Monte Nido Philadelphia Day ... in group and individual therapy, benefit from Monte Nido's clinical , medical, psychiatric and nutritional expertise and experience real...habits by eating meals to completion with clients and staff while working at mealtimes. + At times, the… more
    Monte Nido (11/07/25)
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  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Trenton, NJ)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
    Evolent (12/10/25)
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  • PRN Retail Clinical Pharmacist--as needed,…

    Penn Medicine (Radnor, PA)
    …hyperalimentation, and chemotherapy. + Responsible for participation in all drug utilization evaluations and quality assurance monitors, performing clinical ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
    Penn Medicine (11/06/25)
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  • Lead Technical Analyst - Technical Product Manager

    Highmark Health (Trenton, NJ)
    …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
    Highmark Health (12/02/25)
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  • Penn Medicine Physician Advisor

    Penn Medicine (Philadelphia, PA)
    …resource management , case management , social services, discharge planning, and utilization management to develop and implement methods to optimize use of ... (required) * Possess or develop a solid foundation in the areas of utilization management and hospital operations (required) * Master of Business Administration… more
    Penn Medicine (12/06/25)
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  • Data Management Lead

    Parexel (Trenton, NJ)
    …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
    Parexel (10/11/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Trenton, NJ)
    …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
    Evolent (10/29/25)
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  • Field Medical Director, Cardiology

    Evolent (Trenton, NJ)
    …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
    Evolent (11/14/25)
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