- Appcast (Canton, MA)
- …is Fully remote, but Massachusetts RN license required. Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected ... a clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the determination of medical necessity and, therefore,… more
- Vivian (Kentfield, CA)
- …& RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelOpenwork Health ... Job ID #70389880. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.About Openwork HealthWe're not your average travel nurse agency. At Openwork Health, we're all about helping… more
- Vivian (Kentfield, CA)
- …& RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelPride Health Job ... ID #16605677. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Case Manager,09:00:00-17:00:00About PRIDE HealthPRIDE Health is the minority-owned… more
- AmeriHealth Caritas Health Plan (Wilmington, DE)
- …to efficiently document and assess patient cases Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... compliance Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment Your career starts now. We are looking… more
- Paul Davis Restoration, Inc. (Jacksonville, FL)
- …of the department and network during a catastrophe event. Position: Full-Service Reviewer Reports to: Review Team Manager Location: Hybrid Essential ... Join Our National Team as a Full-Service Reviewer ! Are you looking to leverage your expertise...large losses of all job types. These reviews include utilization of knowledge of industry standards, carrier guidelines, and… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …and people resources, supporting appropriate use of NNI products and greater utilization of its services Takes a leadership role in coordinating activities at ... health care providers Support appropriate use of NNI products and greater utilization of its services Support representatives in answering physicians questions Works… more
- Integrated Home (Hollywood, FL)
- …and interact well with others in any situation Provide updates to Manager of Utilization Management for review What will you come with: State licensure as ... programs Comprehensive paid training program What will you be doing: As a Utilization Management Nurse, you will ensure that home health care services are… more
- Vivian (Cambridge, MA)
- …hours per weekShift: 8 hours, daysEmployment Type: TravelPrimary Responsibilities:1. Performs utilization review and discharge planning to inpatient admissions ... Inpatient criteria approved by the MACIPA (risk) and MAH (non-risk) Utilization Management Committees to accurately determine appropriateness for inpatient and… more
- University Health (San Antonio, TX)
- …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. ... patients, promoting the achievement of optimal clinical and resource utilization allocation; facilitates transitions to facilitate appropriate lengths of stay… more
- Novo Nordisk Inc. (San Francisco, CA)
- …providers and IHNs Develops appropriate use of NNI products and greater utilization of its services Supports and assists representatives and managers in answering ... sites; ensuring effective coordination and facilitation of studies to ensure timely review , initiation, and completion, as well as publication of study results.… more
- Novo Nordisk Inc. (East Cleveland, OH)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- Novo Nordisk Inc. (Detroit, MI)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- TrackFive (New York, NY)
- …to $2,900 per weekAbout The PositionJob Opportunity: Registered Nurse (Case Management - Utilization Review ) Bronx, NY 10457 Duration: 13 Weeks Shift Details ... Experience Prior critical care experience Knowledge of CarePort, MCG, and/or InterQual Utilization Review e.xperience a plus About Lancesoft IncEstablished in… more
- Merck & Co. (Durham, NC)
- …culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply - ... - Responsible for creating and sustaining a highly engaged workforce through utilization of our Company Leadership Behaviors and Inclusion.- Provide coaching on… more
- Merck & Co. (Rahway, NJ)
- …a trusted business partner, playing a critical role in ensuring effective resource utilization , specifically to ensure our Company is spending the right amount on ... and distribution of project budgets, assurance of timely project closure and review of those related business cases from a strategic and governance compliance… more
- TrackFive (San Jose, CA)
- …care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Eisai, Inc (Nutley, NJ)
- …and MSL managers. Develop congress abstract tracker, assign MSL coverage, review MSL reporting responsibilities, collate and distribute Congress Report, execute pre- ... for internal medical training content. Train new hires on EMAC organization/ utilization .Provide input into and collaborate with regional and global medical leads… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …their placement in the treatment continuum as well as appropriate utilization and treatment guidelines Proactively leverages detailed knowledge of all applicable ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications A Bachelor's degree required Master's degree… more
- TrackFive (New York, NY)
- …to policy. Shares in responsibility for productivity and effective resource utilization , including staffing and supplies. Complies with all nursing practice ... students. Engages in quality improvement initiatives and supports peer review practices. Performs other duties as assigned.28036981EXPPLATJob RequirementsRequired for… more
- TrackFive (Colorado Springs, CO)
- …accreditation bodies (TJC & HFAP) preferred. Case Management experience including utilization review and discharge planning preferre About Patterns LLCPatterns ... Patient Safety, and Process Improvement Committees. Assesses data-driven quality topics for review across the hospital, including (a) high risk-high volume, (b) low… more
