- 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
- Molina Healthcare (Los Angeles, CA)
- …of service. **We are seeking a candidate with a RN license and managed care UM experience-required. Prior Inpatient review experience and transplants highly ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (Bowling Green, KY)
- …we are seeking a (RN) Registered Nurse with previous experience in Hospital 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 (Bowling Green, KY)
- …we are seeking a (RN) Registered Nurse with previous experience in Hospital 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 (Covington, 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
- 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
- Molina Healthcare (Riverside, CA)
- …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
- US Tech Solutions (Chicago, IL)
- …+ 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
- 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 Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... NCI U01 grant which aims to integrate and assess an evidence-based survivorship care program in federally qualified health centers. The manager will work in… more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Supervise the daily operations of the utilization management ( UM ) department functions to ensure appropriate coordination of health ... care services and compliance with UR policies/procedures, as well...We are looking for an experienced people leader and clinician in the greater Baltimore metropolitan area who is… more
- Kepro (Indianapolis, IN)
- …or Quality Assurance committee responsibility in a hospital setting. + Utilization Management ( UM ) review experience. + Experience as a physician executive with ... 2+ years as a Medical Director in a managed care company. + Board certification in a clinical specialty...A strong knowledge of Quality Assurance (QA) and Utilization Review (UR). + A contemporary clinician who… 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
- 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
- University of Miami (Miami, FL)
- …pediatrics units, students and residents are active participants in our multidisciplinary care . Our faculty are highly dedicated clinician educators committed to ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Academic Pediatric Hospitalist… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . This ... procedures, and that technical/research personnel is informed of and comply with UM fiscal and personnel policies and procedures; maintains appropriate files and… more
- CVS Health (Hartford, CT)
- …internal/external clinician support as required. This position may support UM , MPO, Coding, or Behavioral Health appeals. **Required Qualifications** + Must have ... 3+ years clinical experience **Preferred Qualifications** + Appeals Experience + Managed Care Experience + Utilization review experience + Proficiency with… more