- Cambia Health Solutions, Inc (Renton, WA)
- …to drive results and achieve key performance metrics.Conducts peer clinical review for medical necessity on utilization management authorization ... Senior Medical DirectorWashington - includes in state and...working closely with the CM clinical staff.Responsible for discussing review determinations with providers who request peer-to-peer conversations.Participates on… more
- Menlo Park (Portland, OR)
- …stand up, Managing Acute Care Conditions (MACC), Nutrition at Risk (NAR), Utilization Review (UR), Quality Assurance Performance Improvement (QAPI) and other ... program including coaching and teaching many staff (Certified Nursing Assistant CNAs, Licensed Practical Nurses LPNs, and Registered Nurses RNs). * A defined and… more
- Elevance Health (Miami, FL)
- ** Licensed Utilization Review Senior ** _Location:_ While remote, candidate should reside within 50 miles of either Tampa or Miami, FL. The ** Licensed ... a LPN, LVN, or RN and minimum of 2 years of clinical or utilization review experience and minimum of 2 years of managed care experience; or any combination… more
- Humana (Columbus, OH)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File Review Universes and timeliness ... of our caring community and help us put health first** We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan… more
- Ascension Health (Wichita, KS)
- **Details** + **Department:** Utilization Review - Behavior Health + **Schedule:** PRN, Day Shift, 8 hr shift, Rotating Weekends and Holidays + **Hospital:** ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000086 1 Date: Apr 22, 2024 Location: LAND O' LAKES, FL, US, 34639 The State Personnel System is an E-Verify employer. For ... . Requisition No: 819687 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000086 1 Pay… more
- Prime Healthcare (Chino, CA)
- …for providing supervision to the case managers, social workers, coordinators/discharge planners, utilization review coordinators and utilization review ... among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top...care needs with top-rated emergency care as well as senior services, orthopedics, surgical services and more. Learn more… more
- Centene Corporation (Little Rock, AR)
- …levels of care and facilities + Partners with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners ... and concurrent review findings + Provides education to providers on utilization processes to ensure high quality appropriate care to members + Partners with… more
- HCA Healthcare (Tampa, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive If you...you to apply for our Mental Health Professional III Licensed opening. We promptly review all applications.… more
- HCA Healthcare (Richmond, VA)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive If you...opportunity compelling, we encourage you to apply for our Licensed Clinical Therapist IOP opening. We promptly review… more
- HCA Healthcare (Aventura, FL)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive If you...you to apply for our Mental Health Prof III Licensed opening. We promptly review all applications.… more
- Johns Hopkins University (Baltimore, MD)
- …development. The Senior Architect is also responsible for oversight of review of work by outside consultants to ensure conformance with the intended program, ... With supervision by the Senior Director of Planning and Architecture and the...and Standards. + Support D&C project managers with technical review of consultant deliverables (program, space utilization … more
- Veterans Affairs, Veterans Health Administration (Brockton, MA)
- …internship or equivalent supervised professional experience in a specialty. (2) Licensure/Certification. Senior social workers must be licensed or certified by a ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Learn more Responsibilities This...by the incumbent at least 25% of the time. Senior social workers are licensed or certified… more
- VIP Care (Tampa, FL)
- …improve utilization and provide better health for patients. The Senior Medical Director would also leverage their entrepreneurial and innovative abilities for ... Summary/Objective: The Senior Medical Director is responsible for leading efforts...ongoing improvements in MHT to lead to improvements in utilization + Direct the integration of the Pharmacy team… more
- Universal Health Services (Sacramento, CA)
- Responsibilities Sierra Vista Hospital is seeking a Lead Licensed Clinician for the Outpatient Services Department. If you're passionate about working in the ... program for new grads! + Rewarding career opportunities The Lead Clinician is a senior level clinical position that serves as the primary contact for the department… 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 ... County of San Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job… more
- Veterans Affairs, Veterans Health Administration (Mcallen, TX)
- …and internship or equivalent supervised professional experience in a specialty. Licensure/Certification. Senior social workers must be licensed or certified by a ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This vacancy will...by the incumbent at least 25% of the time. Senior social workers are licensed or certified… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …and internship or equivalent supervised professional experience in a specialty. Licensure/Certification. Senior social workers must be licensed or certified by a ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This vacancy will remain open until… more
- North Wind Group (Huntsville, AL)
- Location: Huntsville/Birmingham, AL Title: Civil Senior Project Manager Schedule (FT/PT): FT Travel Required: As needed "Large Firm Expertise, Small Firm ... throughout the Southeast region. POSITION PURPOSE: A Project Manager (PM) is an experienced licensed engineer who can define a project, develop a set of tasks to… more
- North Wind Group (Huntsville, AL)
- …by opening more branch offices throughout the Southeast region. POSITION PURPOSE: A Senior Project Manager (SPM) is an experienced, licensed engineer who can ... Location: Birmingham/Huntsville, AL Title: Structural Senior Project Manager Schedule (FT/PT): FT Travel Required: As Needed "Large Firm Expertise, Small Firm… more
