- CenterWell (Columbia, SC)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics + Review clinician schedules and incentive plans to… more
- CenterWell (Arlington, TX)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- CenterWell (Daytona Beach, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
- CenterWell (Kansas City, KS)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization . + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization . + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- CVS Health (Harrisburg, PA)
- …Monday through Friday 8:30-5pm . No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health ... **Position Summary-** + **Master's Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and Licensed Registered Nurse with Psychiatric… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... Integrated Outpatient Senior Clinician FLACRA Penn Yan, NY (Onsite) Full-Time $34.00/Hour...plus. Valid NYS driver's License. Job Summary:The integrated senior clinician is a clinician with demonstrated leadership… more
- City of Durham (Durham, NC)
- …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. + Ability ... Crisis Response Clinician Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5167824) Apply Crisis Response Clinician Salary $66,703.00 -… more
- Hartford HealthCare (Danielson, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and then to the student's home. *_Job Summary_* Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare, and deliver… more
- Molina Healthcare (Louisville, KY)
- …RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and ... JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
- Elevance Health (Miami, FL)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license ... Med Management Clinician Senior- Licensed Nurse **Location:** Miami, FL **Hybrid...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
- HCA Healthcare (Dallas, TX)
- …and other parties as appropriate regarding behavioral services** + **Performs utilization review as assigned** + **Participates in developing department ... hours volunteering in our communities. As a(an) Licensed Intake Clinician - PRN with Medical City Green Oaks Hospital...organization. We are looking for an enthusiastic Licensed Intake Clinician - PRN to help us reach our goals.… more
- Elevance Health (WA)
- …or equivalent. Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... **Medical Management Clinician Associate** Carelon Post Acute Solutions A proud...in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management experience strongly preferred. +… more
- Molina Healthcare (Rio Rancho, NM)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- Molina Healthcare (Covington, KY)
- …or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (North Las Vegas, NV)
- …care unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Dartmouth Health (Keene, NH)
- …critical pathways and outcome measurement preferred. Experience in case management, utilization review and discharge planning preferred. Knowledge of JCAHO/NCQA ... as a member or the Behavioral Health Team, the Master's Level Clinician , in collaboration with physicians and multidisciplinary team members, this position is… more
- Highmark Health (Little Rock, AR)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Molina Healthcare (Sparks, NV)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more