- Optum (Portland, ME)
- …maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources ... Whether you are looking for a role in a clinical setting or supporting those who provide care...Maintains a working knowledge of care management, care coordination changes, utilization review … more
- Pharmacy Careers (Fayetteville, NC)
- Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and ... DUR and prepare stakeholder reports. Qualifications: PharmD with managed care , DUR, or pharmacy benefit experience. Strong Excel/data analytics background… more
- Sonder Health Plans, Inc. (Atlanta, GA)
- …in a managed care environment with Medicare Advantage/Commercial populations, utilization management experience and acute clinical nursing experience *Active ... of this position is to provide operational support and clinical expertise in the areas of health care...*Coordinate case management on complex cases that require additional clinical management support *Conducts initial review of… more
- beBee Careers (Charlottesville, VA)
- …Registered Nurse in Charlottesville, VA.Nurses with experience in pediatric care , clinical pathways, navigation, or utilization review are encouraged to ... apply.Day shift, night shift, and mid shift openings available.Full time, part time, and per diem job types available.Requirements:Possess an ADN/ASN degree or higher from an accredited nursing school.Active and unencumbered Registered Nurse license in the… more
- Health eCareers (Manassas, VA)
- …difference end the day knowing you did. Come join our team.Job Summary:The Unit Clinical Care Coordinator (Unit C3) is responsible for overseeing the admission ... needed to ensure a well-rounded and effective plan.Leads the clinical care team, including nurses, physicians, social...efficient system throughput and optimal patient flow.Partners with virtual Utilization Review (UR) Nurse to align payor… more
- JobAdX (Clinton, MD)
- …or federal surveys.Participates in the completion of the FMS Administrative Clinical Review .PHYSICAL DEMANDS AND WORKING CONDITIONS:The physical demands and ... all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all… more
- JobAdX (Lakeville, MN)
- …bonuses depending on company and individual performance.About this role: As a Clinical Manager with Fresenius Medical Care , you will ensure that ... quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible… more
- JobAdX (Tampa, FL)
- About this role: As a Clinical Manager with Fresenius Medical Care , you will ensure that quality patient care is delivered while maintaining clinical ... will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal… more
- Northwell Health (New York, NY)
- …in care /case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably within ... FlexStaff is seeking a qualified Clinical Manager - Integrated Care Perm...medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager - Care Delivery will… more
- Health eCareers (Las Vegas, NV)
- …concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. The goal of concurrent ... review includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality.… more
- Life Care Center of Kirkland (Kirkland, WA)
- …experience in post acute care setting preferred Prior case management, utilization review , and discharge planning experience preferred Certified Case Manager ... Life Care Center of Kirkland is nestled on the...community events fosters a vibrant and inclusive atmosphere. Life Care of Kirkland has also gone through some veryexciting… more
- JobAdX (Austell, GA)
- …of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking ... and speak English language, optimize the use of technology to support clinical care and holds basic computer skills.Strong interpersonal, collaborative skills… more
- JobAdX (Austell, GA)
- …of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking ... patients, families and significant others receive individualized high quality, safe patient care . They practice in a clinical environment that is administered… more
- Health eCareers (Roseville, CA)
- …agents. Knowledge of emergency medications and drug monitoring.Understanding of drug utilization review and drug usage evaluationKnowledge of Federal and ... and dispensing of medications. Promotes high quality, evidence-based, cost-effective pharmaceutical care . Performs these duties in the clinical areas… more
- Health eCareers (East Point, GA)
- …of technology-enabled clinical services, including case and disease management, utilization management and review , and medication therapy management services ... anxiety, insomnia, etc.?Refer members to appropriate specialists to drive clinical care (Monogram-based specialists or locally-aligned specialists)?Conduct goals… more
- JobAdX (Hiram, GA)
- …of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking ... patients, families and significant others receive individualized high quality, safe patient care . They practice in a clinical environment that is administered… more
- JobAdX (Roswell, GA)
- …of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking ... and speak English language, optimize the use of technology to support clinical care and holds basic computer skills.Strong interpersonal, collaborative skills… more
- Appcast (Texas City, TX)
- …complex behavioral health needs through assessments, care planning, and ongoing monitoringPerform utilization review for higher levels of care based on ... individualized, person-centered care plans addressing behavioral, social, and clinical needsCoordinate with interdisciplinary care teams and community… more
- TrackFive (Jacksonville, FL)
- …accordance with the NFRMC Utilization Review Plan and managed care contractual agreements. Submits clinical information to insurance companies to ensure ... all needs (ie, physical, psycho-social, financial). Participates in IDT rounds, Conducts utilization review , evaluates clinical information, and communicates… more
- JobAdX (Marietta, GA)
- …of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking ... and supports performance improvement inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating… more
