• UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    …collaborates with healthcare providers to facilitate efficient patient care . The Clinical Utilization Review Specialist monitors adherence to hospital ... **Job Summary** The Clinical Utilization Review Specialist ...+ 2-4 years of clinical experience in utilization review, case management, or acute care more
    Community Health Systems (07/09/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (07/08/25)
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  • Utilization Review Specialist

    Hunterdon Health Care System (Flemington, NJ)
    Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient use of ... of an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance… more
    Hunterdon Health Care System (06/13/25)
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  • Utilization Management Specialist

    AdventHealth (Tampa, FL)
    …such as heart failure, cancer and other diseases. **The role youll contribute:** The Utilization Management (UM) Specialist works under the direction of the ... also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience,...Access, Billing, etc.) to ensure unnecessary delays in patient care , discharge or billing. The UM Specialist more
    AdventHealth (07/10/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …by effectively communicating clinical information and advocating for appropriate levels of care . The UR Specialist works closely with clinical staff, ... What you will be doing? The Utilization Review (UR) Specialist is a...for the organization. Success in this role requires strong clinical judgment, documentation skills, familiarity with ASAM criteria, and… more
    BriteLife Recovery (07/03/25)
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  • Utilization Review Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review Specialist to our growing team. The Utilization ... will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for behavioral healthcare services.… more
    Spectrum Billing Solutions (06/06/25)
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  • Pharmacy Specialist - Utilization

    Henry Ford Health System (Troy, MI)
    …regimens to optimize the quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and ... waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental...Pharmacy degree or equivalent experience with evidence of advanced clinical training and knowledge in patient care more
    Henry Ford Health System (07/11/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (AZ)
    …Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services with the goal of maintaining high quality ... group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a… more
    HonorHealth (06/11/25)
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  • Behavioral Health Utilization Review…

    Baylor Scott & White Health (Dallas, TX)
    …Note: Benefits may vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares knowledge with healthcare ... staff. Works closely with Medical Director and Health Services leadership. Manages utilization and formulates policies. The role is integral in navigating healthcare… more
    Baylor Scott & White Health (06/07/25)
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  • Utilization Review Specialist

    Marshfield Clinic (Marshfield, WI)
    …to support the most exciting missions in the world!** **Job Title:** Utilization Review Specialist (Remote Option in Wisconsin) **Cost Center:** 101651289 ... **_Remote work available for Wisconsin residents only_** **JOB SUMMARY** The Utilization Review Specialist , Revenue Cycle Provide quality assurance of… more
    Marshfield Clinic (06/18/25)
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  • Utilization Review Specialist

    Reno Behavioral Healthcare Hospital (Reno, NV)
    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care . The ... care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround...assure compliance with reporting and turnaround times. + Addresses care issues with the Director of Clinical more
    Reno Behavioral Healthcare Hospital (04/27/25)
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  • Utilization Review Specialist , DH

    Nuvance Health (Danbury, CT)
    …managing the cost of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level ... in New York - plus multiple primary and specialty care physician practice's locations, including The Heart Center, a...one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the… more
    Nuvance Health (07/03/25)
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  • Physician Utilization Review…

    Hackensack Meridian Health (Hackensack, NJ)
    …include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care , as outlined in ... The Senior Utilization Review Specialist collaborates with the...and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC.… more
    Hackensack Meridian Health (07/01/25)
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  • Utilization Management Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
    Mount Sinai Health System (07/12/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and authorization ... 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care ... Utilization Management reports to the Director of Utilization Management * Oversees clinical decision review… more
    Commonwealth Care Alliance (05/21/25)
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  • Senior Pharmacy Clinical Specialist

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Senior Pharmacy Clinical Specialist position is responsible for performing expert clinical pharmacist duties enabling the delivery ... safe, effective use of medications. Additional duties for the Senior Pharmacy Clinical Specialist position include precepting pharmacy students and pharmacy… more
    Houston Methodist (06/06/25)
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  • Pharmacy Clinical Specialist - Full…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of ... within the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed… more
    Houston Methodist (07/06/25)
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  • Clinical Pharmacy Specialist

    Veterans Affairs, Veterans Health Administration (Memphis, TN)
    Summary The Clinical Pharmacy Specialist (Ambulatory Care ) is located in Pharmacy Service, Memphis VA Medical Center, Memphis,TN. This position provides ... in Lexington and Louisville, KY, Nashville and Mountain Home, TN. Responsibilities The Clinical Pharmacy Specialist (Ambulatory Care ) is a licensed… more
    Veterans Affairs, Veterans Health Administration (07/03/25)
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  • Clinical Pharmacist ( Specialist

    RWJBarnabas Health (Elizabeth, NJ)
    …with a concentrated focus on Critical Care and Infectious Disease. The Clinical Pharmacist Specialist will have a leading role in Antimicrobial Stewardship, ... Clinical Pharmacist ( Specialist ), PharmacyReq #:0000188073 Category:Pharmacy...Specialist is responsible for the provision of pharmaceutical care to all patient age groups (including geriatric, adult,… more
    RWJBarnabas Health (06/12/25)
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  • Clinical Pharmacy Specialist

    HonorHealth (AZ)
    …because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Ambulatory Care Clinical Pharmacy Specialist provides expert level care ... medication-related outcomes and reduce hospitalizations for at-risk populations. The Ambulatory Care Clinical Pharmacy Specialist will conduct educational… more
    HonorHealth (04/22/25)
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