- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …that balance autonomy, clinical judgment, and meaningful collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse, a ... behind the scenes, this is your moment. As a Clinical Care Reviewer , you'll evaluate inpatient, outpatient,...that make a real difference. This isn't floor work-it's clinical leadership with purpose. What You'll Do: Review… more
- Actalent (St. Paul, MN)
- Clinical Review Pharmacist (100% Remote ) Job Description In this role, you will utilize your clinical skills to conduct utilization management reviews, ... work independently within a team of pharmacy professionals to achieve monthly quality and productivity goals. The position is considered for potential long-term… more
- Glycomine (Boston, MA)
- …skills, written and verbal communication skills, attention to detail, and knowledge of quality obligations. This is a remote based position ideally located in ... develop therapies that can provide meaningful improvements in the quality of life for patients, caregivers, and families. Job...each site activation. Work closely with the Director of Clinical Operations to review the study timelines… more
- UnitedHealth Group (Minneapolis, MN)
- …with medical director teams focusing on inpatient care management, clinical coverage review , member appeals clinical review , medical claim review ... are currently seeking a Utilization Management Medical Director to join our Clinical Performance team. This team is responsible for conducting hospital and… more
- Actalent (St. Louis, MO)
- Clinical Review Pharmacist - 100% Remote $55/hr | Full-Time | Contract-to-Hire | Make a Real Impact from Anywhere Why This Role Rocks Join a team of pharmacy ... this fully remote role, you'll use your clinical expertise to review and approve (or...of utilization management requests Assess coverage requests with client-specific clinical criteria Meet monthly targets for quality … more
- Actalent (Denver, CO)
- …clinical judgment. Communicate timely with internal teams, investigators, review boards, and study subjects. Perform protocol-mandated visits, including providing ... assist patients in achieving their nutritional and physical activity goals. Attend remote , video-assisted protocol visits. Review applicable study logs, collect… more
- UnitedHealth Group (Metairie, LA)
- …CMO is responsible for the achievement of goals for contractually required clinical Quality Performance Indicators and state regulator-driven pay-for- quality ... clinical operations, by providing oversight and guidance around quality improvement, appropriate inpatient and outpatient utilization, affordability, growth,… more
- UnitedHealth Group (Kalamazoo, MI)
- …team while overseeing day-to-day clinical operations and health plan clinical initiatives to support achieving quality and affordability targets. The ... simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of… more
- Veterans Health Administration (Chesapeake, VA)
- …and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, ... and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation,… more
- Swell Health (Smyrna, TN)
- …Licensed Mental Health Therapist, Telehealth LMFT - Licensed Marriage and Family Therapist, Remote LCSW - Licensed Clinical Social Worker, Remote LPC-MHSP ... - Licensed Professional Counselor, Remote Location: Remote , must have license in KY or TN Experience:...of your clients, monitoring outcomes over time. Assign & review in-app homework (video modules, daily journaling, check-ins, etc)… more
- Veterans Health Administration (Los Angeles, CA)
- …and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, ... and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation,… more
- Veterans Health Administration (White River Junction, VT)
- …candidate must demonstrate the following KSAs: Knowledge of policies and procedures of clinical laboratory testing. Knowledge of laboratory quality control and ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. This job is open...medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid… more
- UnitedHealth Group (Detroit, MI)
- …The responsibilities include working collaboratively with the Health Plan Medical Director, Clinical , Network and Quality staff. At Optum, our clinical ... Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review , case management, and care coordination… more
- Veterans Health Administration (Salt Lake City, UT)
- … control procedures and checks to ensure accurate test results are reported. Assists in quality control review and input of QC data into offline system for ... the following KSAs: Knowledge of policies and procedures of clinical laboratory testing. Knowledge of laboratory quality ...medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid… more
- Tolmar (Okemos, MI)
- …federal hospitals and formulary committees. The AMRU is responsible for ensuring customer's clinical conviction in the product and seeing the sale through to its ... *Demonstrate thorough knowledge of products by effectively communicating appropriate clinical , technical, therapeutic, disease state and product information to… more
- Veterans Health Administration (Miami, FL)
- …approach, from assessment and intervention to evaluation and advocacy, in delivering quality healthcare. The certified Clinical Nurse Leader (CNL) utilizes the ... the healthcare delivery. Apply improvement science to enhance performance measurement and quality improvement. The Clinical Nurse Leader (CNL) duties include but… more
- EnableComp (Franklin, TN)
- …RCM analyst workflow requirements Establish and enforce development standards, code review processes, and deployment protocols Recruit, develop, and retain senior ... tools across engineering teams with measurable productivity targets Establish architecture review board and technical debt reduction initiatives Report directly to… more
- Pima Medical Institute (Aurora, CO)
- …: Aurora Campus Schedule : Part-Time (Thurs-Fri, 7 AM-5 PM) | 20 hrs/week (16 clinical , 4 remote grading) Compensation : $37.51-$46.59/hr + ESOP | 401(k) | ... This part-time role offers a flexible hybrid schedule, including remote grading and campus lab instruction, plus clinical...Track student progress and create success plans Partner with clinical sites to ensure quality learning environments… more
- Veterans Health Administration (Oklahoma City, OK)
- …and sound judgment to ensure cases are provided with a thorough, comprehensive review when appropriate. The CSP Clinical Assessor demonstrates knowledge and ... Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the...medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid… more
- Kestra Medical Technologies, Inc (Detroit, MI)
- …*Support follow-up tasks for renewals, discharge dates, delivery documentation, and clinical documentation. * Review CareStation reports for patient triggered ... modern wearable technologies with proven device therapies. Kestra's solutions combine high quality and technical performance with a wearable design that provides the… more
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