- Molina Healthcare (New York, NY)
- …people who are eligible for Medicaid .** **We are looking for a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
- Insight Global (Long Beach, CA)
- Job Description Insight Global is looking for a passionate and experienced Care Review Clinician to join their team. This role will be remote working off of ... to determine financial responsibility for the company and its members. Each nurse will care for 25-30 cases. Across the LA county, they are caring for around 500… more
- Molina Healthcare (Long Beach, CA)
- **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE** **For this position we are seeking a (RN) Registered Nurse with previous ... experience in Acute Care , Concurrent Review / Utilization Review ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Molina Healthcare (SC)
- **_JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW BEHAVIORAL HEALTH : REGISTERED NURSE (2 openings)_** **_For this position we are seeking a (RN) ... Registered Nurse with previous experience in Behavioral Health Acute Care , Concurrent Review / Utilization Review ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Molina Healthcare (Amarillo, TX)
- … Care Model * Adhere to UM policies and procedures * Mentor New Care Review Clinicians during orientation period *Sign off on core competencies for new ... Care Review Clinicians during peer mentoring phase *Model New programs, techniques and trainings with peers. **Job Qualifications** **Required Education**… more
- Molina Healthcare (KY)
- …position we are seeking a (RN) Registered Nurse with previous experience in Acute Care , Concurrent Review / Utilization Review / Utilization Management and ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (TX)
- …position we are seeking a (RN) Registered Nurse with previous experience in Acute Care , Concurrent Review / Utilization Review / Utilization Management and ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (Long Beach, CA)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... shift from then on._** **_Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is… more
- Molina Healthcare (Fredericksburg, VA)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Molina Healthcare (Louisville, KY)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Molina Healthcare (Lexington, KY)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- Centene Corporation (Tallahassee, FL)
- …review process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse ... UTILIZATION MANAGEMENT FOR MEDICAID. **Position Purpose:** Performs a clinical review and assesses care related to mental...UM role will be focusing on outlier management review of provider records with an overall objective of:… more
- University of Michigan (Ann Arbor, MI)
- Doctorate Level Mental Health Clinician Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the first ... Diversity, Equity, and Inclusion Initiatives + Clinical documentation + Clinical care coordination as needed (eg, with community providers, UHS, Michigan Medicine… more
- University of Michigan (Ann Arbor, MI)
- Masters Level Mental Health Clinician Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the first ... Diversity, Equity, and Inclusion Initiatives + Clinical documentation + Clinical care coordination as needed (eg, with community providers, UHS, Michigan Medicine… more
- US Tech Solutions (May, OK)
- …. MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. .… more
- University of Michigan (Ann Arbor, MI)
- …bill directly for their services, and must have a certified clinician countersign all patient encounter notes. **Responsibilities **Clinical Experience:** + Each ... resident will shadow a UMOPC clinician as he/she attends to his/her various roles. As...coordinate rehabilitation activities with medical staff and other health care disciplines **Research Experience:** + Each resident is required… more
- Kepro (Indianapolis, IN)
- …Examiners in the State of Indiana, Michigan, or Illinois + Utilization Management ( UM ) review experience + Experience as a physician executive with significant ... accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization...A strong knowledge of Quality Assurance (QA) and Utilization Review (UR) + A contemporary clinician who… more
- University of Michigan (Ann Arbor, MI)
- …and wellness care to University of Michigan students, as well as primary care services for eligible UM faculty and staff. UHS is actively seeing ... UHS. MAs are frontline in providing the highest quality care for students and other UM affiliated...families according to the teaching plan established by a clinician **Required Qualifications + High school diploma or GED… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) The Case Manager is accountable to facilitate the interdisciplinary team to ... plan, coordinate, implement and evaluate patient care for assigned service line across the...community, patient/significant others/family and payers by functioning as a clinician , consultant, advocate and educator for assigned service.The Case… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more