- University of Maryland Medical System (Baltimore, MD)
- …in the nation. Patients and professionals alike appreciate the unique advantages offered here at UM Rehab & Ortho Institute. As a Registered Nurse at UM Rehab & ... roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a...Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member… more
- University of Maryland Medical System (Ilchester, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... role is designed for the nurse who is a clinical and professional leader at the unit level. Demonstrates...ancillary personnel's skills and development; leads unit based peer review processes. Actively engaged in advancing own practice; role… more
- University of Maryland Medical System (Bel Air, MD)
- Company Description University of Maryland Upper Chesapeake Health ( UM UCH) offers the residents of northeastern Maryland an unparalleled combination of clinical ... as a resource for health promotion and education. Today, UM UCH is the leading health care system and...Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member… more
- University of Maryland Medical System (Baltimore, MD)
- …in the nation. Patients and professionals alike appreciate the unique advantages offered here at UM Rehab & Ortho Institute. As a Registered Nurse at UM Rehab & ... roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a...Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member… more
- University of Maryland Medical System (Baltimore, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... in the nation. Patients and professionals alike appreciate the unique advantages offered here at UM Rehab & Ortho Institute. As a Registered Nurse at UM Rehab &… more
- Christus Health (Johnson City, TX)
- … services for patients and analyze information supplied by physicians (or other clinical staff) to make timely review determinations, based on appropriate ... description.Summary:The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper… more
- Centene (Keizer, OR)
- …perspective on workplace flexibility. Position Purpose: Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... between utilization management team, members, and providers Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses and… more
- University of Maryland Medical System (Bel Air, MD)
- …steroid-free protocol and pancreas/kidney transplant. From our National Cancer Institute-designated UM Marlene and Stewart Greenebaum Cancer Center to The University ... $5,000 Sign On Bonus Full Time, Night shift, 7p-7a UM Upper Chesapeake Health, Bel Air, MD General Summary...of all job duties performed by personnel so classified. Clinical Practice/Care Delivery Focus of clinical practice/care… more
- University of Maryland Medical System (Towson, MD)
- …We're making Maryland stronger! With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological ... months experience. Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member of the… more
- University of Maryland Medical System (Bel Air, MD)
- …steroid-free protocol and pancreas/kidney transplant. From our National Cancer Institute-designated UM Marlene and Stewart Greenebaum Cancer Center to The University ... Provides and coordinates independent care to patients within a clinical specialty as a fully effective and participative member...at the unit level. 6. Provides feedback in peer review as requested. Provides direct performance feedback at the… more
- University of Miami (Miami, FL)
- …(For Non-exempt Employees Include Percent of Effort):Meets requirements of Clinical Trials Chemotherapy Nurse 50%Works closely with the medical director ... protocol. Assists in maintenance of up-to-date protocol information in clinical areas. Documents in a concise, accurate and legible...have been performed and received for the physician to review the findings. Develops a system that elevates any… more
- Albany Medical Center Careers (Delmar, NY)
- …to coordinate the appropriate use of resources to achieve maximum clinical and financial outcomes.Salary Range: $65,057.00 - $107,348.80Weekend Commitment: Approx. 4 ... of care in the hospital pre and post-op.b. Proactively monitor patients' clinical process through /patient care standards and evidence-based guidelines to ensure… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, July 1, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help… more
- Kepro (Indianapolis, IN)
- …vital partner for health solutions in the public sector. Acentra seeks a Utilization Management ( UM ) Nurse Clinical Reviewer - LPN/RN (Remote US) to join our ... Summary: The purpose of this position is to utilize clinical expertise to review medical records against...Degree Nursing Program. + 2+ years of Utilization Management ( UM ) experience from the State, Hospital, or Health Plan.… more
- CVS Health (Pittsburgh, PA)
- … Clinical Operations, Clinical Account Management, Formulary Administration, and Clinical Affairs. The UM Clinical Development pharmacist may be ... more personal, convenient and affordable. Position Summary The Utilization Management ( UM ) clinical development pharmacist will develop clinically and ethically… more
- Molina Healthcare (Nacogdoches, TX)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), ... or related field. **Required Experience** + Minimum two years UM , CM, MAT, HM, DM, and/or managed care experience....medical or behavioral health settings. + Two years of clinical auditing/ review experience. To all current Molina… more
- AmeriHealth Caritas (Orlando, FL)
- **Medical Director, UM Review , Family Medicine** Location: Orlando, FL Primary Job Function: Medical Management ID**: 31409 **Job Brief** Must be able to ... where ACFC has a line of business within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your career starts now. We are… more
- Healthfirst (NY)
- …approvals from key governance committee members. + Review the appropriate UM or related clinical and medical policies, job aids/procedures, and ... spearhead the policy work that will inform Medical and Clinical strategy + Perform editorial formatting and review...ad hoc medical condition research per Medical Director and/or UM Clinical Director requests. + Collaborate with… more
- The Cigna Group (Franklin, TN)
- … clinical compliance within the UM programs, including matters concerning clinical policy, quality management (QM), program development, review of UM ... **Responsibilities and Essential Functions** + Responsible for development of clinical policy, clinical review decisions,...Client teams for clinical matters related to UM client contracts + Review official program… more
- Fallon Health (Worcester, MA)
- …maintenance of existing letters and rollout of new letters. Collaborates closely with the UM Clinical and Prior Auth staff to ensure appropriate and applicable ... nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,...This position serves as the subject matter expert on UM letters, and works in conjunction with other FH… more
