- Molina Healthcare (Louisville, KY)
- …of KY or 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 ... to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and… more
- Molina Healthcare (Tacoma, WA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Tacoma, WA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Mount Pleasant, SC)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Point32Health (MA)
- …to applicable regulatory guidelines and Enterprise contract requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership ... including demonstrating the behaviors that support teamwork, collaboration, and professionalism. The BH UM clinician works under the direction of the UM … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Nurse, Quality Review Utilization Management ( UM ) is to evaluate clinical quality and procedures within ... the Utilization Management ( UM ) program to maximize efficiency, ensure compliance and optimize...program to maximize efficiency, ensure compliance and optimize patient care and safety. This position supports utilization management across… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Certification in utilization management or a related field. * Experience in UM /CM/QA/Managed Care . * Knowledge of state and/or federal regulatory policies ... * Certification in utilization management or a related field. * Experience in UM /CM/QA/Managed Care . * Knowledge of state and/or federal regulatory policies… 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 Michigan (Ann Arbor, MI)
- Advanced Practice Professional (Nurse Practitioner) D. Dan and Betty Kahn Health Care Pavilion: Cardiac Surgery Inpatient Service Apply Now **How to Apply** This is ... **Job Summary** The D. Dan and Betty Kahn Health Care Pavilion is a 12-story hospital that will house...the cardiac surgery service. Specifically, the role requires the clinician to: + Manage pre- and post-cardiac surgery patients… more
- University of Michigan (Ann Arbor, MI)
- …post-surgical Adult/Late Adult patients admitted to the Cardiac Surgery Service intensive care setting. Specifically, role requires clinician to: + Perform ... patients, populations and communities through excellence in education, patient care , community service, research and technology development, and through leadership… more
- University of Miami (Miami, FL)
- …apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department ... an Assistant Professor of Clinical in Pediatric Adolescent Gynecology on the Clinician Educator track will have clinical responsibilities within the Department of… 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
- 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