- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Opportunity for experienced Utilization Review RN in the state of Texas. You will be hired to join the inpatient review team doing initial ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- POSITION TITLE: Utilization Review Clinician REPORTS TO (TITLE): Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary ... treatment team reviewing patient care and treatment options for both inpatient and outpatient...payers. + Recordkeeping: Maintains appropriate records of the Utilization Review Department. + Training: Provide staff in-service training and… more
- 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 ... flexible and willing to work holidays. This is a remote position, and you may work from home._** **_Further...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long… more
- City of Durham (Durham, NC)
- …encountered emergency services. Its primary goal is to provide individuals with quality remote care and/or connect individuals to in-person care . + ... Crisis Response Clinician Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/4689381) Apply Crisis Response ...meet the needs of people in crisis with compassionate care and behavioral health expertise. In the first twelve… more
- Centene Corporation (Jefferson City, MO)
- …review process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse ... including a fresh perspective on workplace flexibility. POSITION IS REMOTE WORK HOURS FOR FIRST 90 DAYS WILL BE...SATURDAY POTENTIAL FOR HOLIDAYS **Position Purpose:** Performs a clinical review and assesses care related to mental… more
- State of Colorado (Denver, CO)
- …Preferred Qualifications: + 1+ years of Knowledge and Experience as a Mental Health Care Clinician I at the State of Colorado Mental Health Institute. + ... Mental Health Clinician I - Forensics/Civil- Colorado Mental Health Hospital...Medical services, o ccupational therapy, neuropsychological-rehabilitation services, and trauma-informed care services are available for all patients throughout the… more
- State of Colorado (Denver, CO)
- …treatment planning. + Advocate for patient's interest and input into their plan of care . Supports Mental Health Clinician I staff in further development of their ... Mental Health Clinician I/ Fort Logan Nursing Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4734661) Apply Mental Health Clinician I/… more
- Elevance Health (Indianapolis, IN)
- **Medical Management Clinician Sr** **LOCATION** **: Indianapolis, Indiana.** This is a remote position working from home; however, the ideal candidate will live ... Health PulsePoint location in Indianapolis, Indiana. The **Medical Management Clinician Sr** is responsible for ensuring appropriate, consistent administration of… more
- The Joint Commission (Oakbrook Terrace, IL)
- …SUMMARY** Field Representatives, with minimal direction or supervision, survey and/or review health care organizations throughout the United States. Field ... of policies, evidence of performance improvement, and quality and safety of care . 2. Using Joint Commission's established survey/ review process, exercise… more
- Highmark Health (Columbus, OH)
- …for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line ... clinical data to assess potential stop loss and managed care claim liability and utilize Case Management oversight techniques...has a direct impact on the profitabiliy of the company. Review all triaged notices of potential claims and make… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Physician Assistant- Surgical Advanced Practice Clinician (Surgical APC) practices in Surgical Care Service to provide a full range of services ... participate clinically in the development of the PA patient care audit processes involving in-depth review and...medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If… more
- Insight Global (Lanham, MD)
- …MD. The Licensed Clinician will work in tandem with the primary care team and is responsible for providing brief intervention and consultation to patients in ... referrals to patients with higher behavioral health needs; coordinating care for complex patients with mental and physical health...on-site. after 90 days, can transition to 3 days/week remote ! We are a company committed to creating diverse… more
- SteadyMD (Thousand Oaks, CA)
- …Just to name a few! Position Overview: + Role: Nurse Practitioner for Virtual Patient Care + Location: Fully Remote + Schedule: Available 10 hours a week, ... + Comfortable with complex chronic condition management preference + Telemedicine or virtual care experience is preferred Benefits + Fully Remote work with… more
- RWJBarnabas Health (Oceanport, NJ)
- …+ Must have proficiency with online nationally recognized UM criteria, including Milliman Care Guidelines (MCG) and/or InterQual (IQ). + Review patient medical ... Category:Billing/Collections/Registration Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:Appeals Location: Remote , 2 Crescent Place, Oceanport, NJ 07757 Job Overview:… more
- Trinity Health (Livonia, MI)
- …(COS-C) can be obtained within 6 months of hire. HCS-O is helpful. Remote position. **Clinical Quality Review Specialist Position Summary - REMOTE ... can be obtained within 6 months of hire.** The Clinical Quality Review Specialist is responsible processing and completing assigned quality and clinical workflows,… more
- SteadyMD (Thousand Oaks, CA)
- …Just to name a few! Position Overview: + Role: Nurse Practitioner for Virtual Patient Care + Location: Fully Remote + Schedule: Available 10 hours a week, ... + Comfortable with complex chronic condition management preference + Telemedicine or virtual care experience is preferred Benefits + Fully Remote work with… more
- SteadyMD (Thousand Oaks, CA)
- …average comfort with technology + Timely and professional + Telemedicine or virtual care experience preferred Benefits + Fully Remote work with flexible hours ... facilitating modern healthcare services. Our comprehensive platform, supported by a clinician workforce licensed across all 50 states, streamlines telehealth for… more
- Kepro (WI)
- …Employee Assistance Program (EAP) Consultant - Part-time at Acentra Health, the licensed clinician will provide a full range of EAP services for employees, managers, ... + Consistently provide exceptional and proactive services as a licensed clinician , ensuring smooth integration with Acentra Health operations and accounts. +… more
- Prime Therapeutics (Columbus, OH)
- …decision we make. **Job Posting Title** Data Scientist/Clinical exp preferred- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory, wellness program data, etc.). This… more
- Molina Healthcare (NM)
- …barriers to care ); preparation for Quality Improvement Compliance surveys; preparation and review of potential quality of care and critical incident cases; ... of medical record documentation for credentialing and model of care oversight; and any other federal and state required...to focus on parts of the process where a clinician 's perspective would be valuable to uncover process gaps… more