- Elevance Health (Tampa, FL)
- ** Licensed Utilization Review Senior ** _Location:_ While remote, candidate should reside within 50 miles of either Tampa or Miami, FL. The ** Licensed ... a LPN, LVN, or RN and minimum of 2 years of clinical or utilization review experience and minimum of 2 years of managed care experience; or any combination… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Utilization Review + **Schedule:** Part Time + **Hospital:** Ascension St. Vincent's Riverside Hospital + **Location:** ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000034 Date: Aug 28, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 832463 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000034 Pay Plan:… more
- Centene Corporation (Sacramento, CA)
- …levels of care and facilities + Partners with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners ... and concurrent review findings + Provides education to providers on utilization processes to ensure high quality appropriate care to members + Partners with… more
- Magellan Health Services (Dallas, TX)
- …appropriate for complex case management and timely completion of all utilization management activities. Involvement in the development of case management plans. ... + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that… more
- MTC (Raymondville, TX)
- …utilize appropriate sanitation methods. 7. Practice basic cost containment and utilization management for detainee care and facility operations. 8. Maintain absolute ... and maintain narrative, statistical, summary and operational records, reports, and logs. 14. Review and process all reports and documents in a timely manner. 15.… more
- VNS Health (Queens, NY)
- …Participates and consults with team supervisor in case conferences, staff meetings, utilization review and discharge planning meetings to determine if ... symptoms to help them remain safely in the community This is a senior , master's level, licensed social services role that provides direct care as part of a team.… more
- Magellan Health Services (Albuquerque, NM)
- …to an assigned interdisciplinary UM team. + Responsible for the quality of utilization review determinations, including appeals. + Reviews cases, makes medical ... is remote in New Mexico, candidates must be NM licensed and reside in NM. This position supports the...effectiveness and cost of care of clinical programs through review and analysis of utilization and financial… more
- City and County of San Francisco (San Francisco, CA)
- …permanent 2932 positions + All City departments with open permanent positions can review your application Under direction, the 2932 Senior Behavioral Health ... Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health...the California Board of Behavioral Sciences (BBS) for + Licensed Clinical Social Worker (LCSW) OR + Licensed… more
- Johns Hopkins University (Baltimore, MD)
- …of clinicians from a range of disciplines (social workers, psychologists, and licensed professional counselors), the Senior Associate Director is also ... a diverse community of learners. Reporting to the Director of Clinical Services, the Senior Associate Director is a key member of the newly expanded and restructured… more
- The Cigna Group (Morris Plains, NJ)
- …management edits at point of service, preferred drug list strategy, retrospective utilization review , risk management review and condition-specific ... oversite of implementation activities related to formulary management and utilization management on the pharmacy and medical benefit to...class strategy + Responsible for the oversight of the review and audit of all Health Plan Value Assessment… more
- WellSense (Boston, MA)
- …healthcare organization required . Minimum five years of experience with prior authorization, utilization review , and discharge planning . Minimum of three years ... that works for our members, no matter their circumstances. **Job Summary:** The Senior Manager of Clinical Utilization Management (UM), Behavioral Health is… more
- North Wind Group (Nashville, TN)
- …by opening more branch offices throughout the Southeast region. POSITION PURPOSE: A Senior Project Manager (SPM) is an experienced, licensed engineer who can ... Location: Birmingham/Huntsville, AL & Nashville, TN Title: Structural Senior Project Manager Schedule (FT/PT): FT Travel Required: As Needed "Large Firm Expertise,… more
- North Wind Group (Birmingham, AL)
- Location: Huntsville/Birmingham, AL Title: Civil Senior Project Manager Schedule (FT/PT): FT Travel Required: As needed "Large Firm Expertise, Small Firm ... throughout the Southeast region. POSITION PURPOSE: A Project Manager (PM) is an experienced licensed engineer who can define a project, develop a set of tasks to… more
- Veterans Affairs, Veterans Health Administration (Springfield, MO)
- …description of duties to be found qualified for this position/grade level. Advanced Licensure. Senior social workers must be licensed or certified by a state at ... determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities If you ARE NOT a current,… more
- Pfizer (Groton, CT)
- …contribution will directly impact patients. **What You Will Achieve** The Rare Disease, Senior Health & Science Specialist (SHSS) - Rare Cardiac, will target health ... will report into the Area Business Manager (ABM). The Senior Health & Science Specialist (SHSS) will demonstrate strong...in local planning + Act decisively by prioritizing resource utilization to meet customer needs + Provide key HQ… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... clinical operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… more
- AECOM (New York, NY)
- …better world. Join us. **Job Description** **AECOM** is currently seeking a Senior Electrical Commissioning Engineer to support programs throughout the US and OCONUS ... regions. This is an onsite position. The Senior Electrical Commissioning Engineer will be responsible for leading and managing technical assignments and ensuring the… more
- MyFlorida (Macclenny, FL)
- SENIOR REGISTERED NURSE SUPV - 60022045 Date: Aug 23, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 807710 Agency: Children and Families Working Title: SENIOR REGISTERED NURSE SUPV - 60022045 Position Number: 60022045 Salary: $2413.22… more