- Molina Healthcare (Louisville, KY)
- …of KY or RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for ... to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $35.00-44.19 Per Hour ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
- Molina Healthcare (NM)
- …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
- Molina Healthcare (Sparks, NV)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Yonkers, NY)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (North Las Vegas, NV)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Orem, UT)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Madison, WI)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Point32Health (MA)
- …to applicable regulatory guidelines and Enterprise contract requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership ... including demonstrating the behaviors that support teamwork, collaboration, and professionalism. The BH UM clinician works under the direction of the UM … more
- AmeriHealth Caritas (LA)
- …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion to retain ... and recognize care coordination opportunities and refer those cases to integrated care management as needed. The BH UM Reviewer will apply medical health… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Certification in utilization management or a related field. * Experience in UM /CM/QA/Managed Care . * Knowledge of state and/or federal regulatory policies ... * Certification in utilization management or a related field. * Experience in UM /CM/QA/Managed Care . * Knowledge of state and/or federal regulatory policies… more
- US Tech Solutions (Chicago, IL)
- …+ 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
- 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)
- Advanced Practice Professional (Nurse Practitioner) D. Dan and Betty Kahn Health Care Pavilion: Cardiac Surgery Inpatient Service Apply Now **How to Apply** This is ... **Job Summary** The D. Dan and Betty Kahn Health Care Pavilion is a 12-story hospital that will house...the cardiac surgery service. Specifically, the role requires the clinician to: + Manage pre- and post-cardiac surgery patients… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- University of Michigan (Ann Arbor, MI)
- …Medicine is seeking a full-time Registered Dietitian Nutritionist (RDN) to provide nutrition care to a variety of medical and surgical patients. This position will ... perform nutrition assessments and develop nutrition care plans using the Academy of Nutrition and Dietetics...+ Certified Diabetes Educator (CDE) + Certified Nutrition Support Clinician (CNSC) + Certified Specialist in Oncology Nutrition (CSO)… more
- University of Miami (Miami, FL)
- …apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department ... an Assistant Professor of Clinical in Pediatric Adolescent Gynecology on the Clinician Educator track will have clinical responsibilities within the Department of… 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