- 4S (Bethesda, MD)
- …in the Peer Review Program as appropriate for the specific licensed clinical specialty of the contract provider. Required Experience, Skills, Background: ... Bethesda, Maryland program location. Service dog training experience or utilization is preferred. If you are a passionate, experience,...and at least two years of experience as a licensed clinical social worker (LCSW), occupational therapist… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …on a designated shift including the effective and efficient allocation, utilization , and management of the financial, human, and material resources. Demonstrates ... expertise in clinical assessment and technical skills procedures. Makes general hospital...policies and procedures. Minimum Job QualificationsLicensure or other certifications: Licensed to practice as an RN in Georgia. National… more
- Marion County (Salem, OR)
- …Health and Human Services is looking for a positive, adaptable, and collaborative Clinical Supervisor to work in the Adult Behavioral Health team! This position will ... be responsible for oversight and support of clinical teams that provide outpatient treatment and support services to individuals who are diagnosed with serious… more
- Cambia Health Solutions, Inc (Boise, ID)
- …data, including patient specific and population-based data, in a manner which facilitates clinical review and decisions by Clinical Pharmacist Consultants. ... authorization requests, reconsiderations, and appeals. Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …be able to function in the charge role if needed, thus maintaining clinical competencies of the nursing specialty he/she leads. The Nurse Manager coordinates, ... and other nursing support personnel, the Nurse Manager directly supervises the clinical nursing and ancillary personnel assigned to a unit or care delivery… more
- Signet Health (Clinton, MD)
- …agencies regarding Case management members. Collaboration with Community Support Programs. Utilization Review for Designated Hospitalized members. Phone Coverage ... program with active compact Registered Nurse license for Maryland required OR Licensed Clinical Social Worker (LCSW-C) or Licensed Clinical Professional… more
- Northeast Georgia Health System, Inc (Demorest, GA)
- …support from Charge Nurses and Educators, the Nurse Manager directly supervises the clinical nursing and ancillary nursing personnel assigned to a unit or care ... of the unit and staff including stat orders, treatments, plans of care, and clinical pathways are being carried out in a consistent manner. The Nurse Manager has… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to ... aligns with patient needs using resources to meet quality, clinical and cost effective outcomes. Coordinates a team approach...to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent… more
- Compass Health Network (Camdenton, MO)
- …needs to support personal recovery.Acts as team lead; assuming responsibility for review of clinical documentation and completion of team/staff AIMS, time ... toward departmental strategic plan goalsActs as team lead; assuming responsibility for review of clinical documentation and completion of team/staff AIMS, time… more
- Signet Health (Clinton, MD)
- …agencies regarding Case management members Collaboration with Community Support Programs Utilization Review for Designated Hospitalized members Phone Coverage ... work with a great team! We look for qualified licensed professionals and place our trust in our employees...may be high risk, high utilizing and at significant clinical risk Perform Telephone Assessments of Mental Health needs… more
- HCA Healthcare (Miami, FL)
- …participates in the Utilization Review process. + The PHP/IOP Licensed Clinical Social Worker participates in community outreach and is involved in ... Do you want to join an organization that invests in you as a(an) Licensed Clinical Social Worker? At HCA Florida Mercy Hospital, you come first. HCA Healthcare… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete...+ Experience: Requires a minimum of 2 years of clinical and utilization review experience… more
- Elevance Health (Miami, FL)
- ** Licensed Utilization Review Senior** _Location:_...LVN, or RN and minimum of 2 years of clinical or utilization review experience and ... candidate should reside within 50 miles of either Tampa or Miami, FL. The ** Licensed Utilization Review Senior** is responsible for working with healthcare… more
- University of Colorado (Aurora, CO)
- Clinical Utilization Review Specialist - 32339...Two (2) years of experience in the SUD field. + Licensed as LCSW, LPC, LMFT, or PsyD. + Experience with ... Medical Campus** **School of Medicine | Department of Psychiatry** **Job Title: Clinical Utilization Review Specialist** **Position: #00217340 - Requisition:… more
- Children's Mercy Kansas City (Kansas City, MO)
- …guidelines, and oversight of clinical denials/appeals. The Manager of Utilization Review participates in department and hospital performance improvement ... lives of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient teams and assist… more
- CVS Health (Baton Rouge, LA)
- …rotating weekend and holiday schedules. Preferred Qualifications: + Managed care/ utilization review experience preferred + Experience in a behavioral ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- CVS Health (Frankfort, KY)
- …the standard schedule based on business needs Preferred Qualifications: + Managed care/ utilization review experience preferred + Experience in a behavioral ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- Centene Corporation (Tallahassee, FL)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Centene Corporation (Helena, MT)
- …assess ABA Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with providers and healthcare ... by the applicable state required. Master's degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or… more
- Universal Health Services (Harahan, LA)
- …and intensive outpatient). River Oaks Hospital is seeking a dynamic and talented UTILIZATION REVIEW DIRECTOR to direct and serve within the Utilization ... and advocates for patient length of stay and level of care. Coordinates utilization review activities with other departments to ensure reimbursement for services… more
