- Molina Healthcare (Bronx, NY)
- …are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review Clinician must be able to work independently in a high-volume ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina… more
- Molina Healthcare (Bronx, NY)
- …eligible for Medicaid and Medicare.** **We are looking for a LPN or LVN Care Review Clinician with Prior Authorization experience. Experience with ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. **JOB… more
- Molina Healthcare (Long Beach, CA)
- **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE** **For this position we are seeking a (RN) Registered Nurse with previous ... experience in Acute Care , Concurrent Review / Utilization Review ...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Molina Healthcare (Omaha, NE)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... licensed in the state of Nebraska. This position supports our Inpatient Medical review process with our Nebraska Medicaid Health Plan. Strong experience with appeals… more
- Molina Healthcare (NE)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... in the state of Nebraska. This position supports our Prior Authorization review process with our Nebraska Medicaid Health Plan. Strong experience with utilization… more
- Molina Healthcare (CA)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... shift from then on._** **_Previous experience with Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is… more
- Molina Healthcare (NE)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... providers who have experience doing these types of reviews within another Managed Care Organization. This is a fully remote position, working from home, Monday -… 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)
- …use of ambulatory surgery centers. To-date at Michigan Medicine, this project has reduced clinician staff effort needed to review cases by 100s of hours while ... to support the expansion of multiple innovations in surgical care . This role would be within the Michigan Program...(MPU), and b) by exploring possible model use with UM -Health affiliate partners to expand its impact beyond Michigan… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) The Case Manager is accountable to facilitate the interdisciplinary team to ... plan, coordinate, implement and evaluate patient care for assigned service line across the...community, patient/significant others/family and payers by functioning as a clinician , consultant, advocate and educator for assigned service.The Case… more
- University of Michigan (Ann Arbor, MI)
- …patients, populations and communities through excellence in education, patient care , community service, research and technology development, and through leadership ... guided by our Strategic Principles and has three critical components; patient care , education and research that together enhance our contribution to society. **Why… 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
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . This ... procedures, and that technical/research personnel is informed of and comply with UM fiscal and personnel policies and procedures; maintains appropriate files and… more