Showing 1-20 of 18,876
Showing 1-20 of 18,876
Utilization Management Clinical jobs

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OhioHealthColumbus, OH

Maintains compliancy with regulation changes affecting utilization management. This position assists in development, implementation, and revision of the...

Northeast Georgia Health SystemGainesville, GA

Insurance Case Management, Workers Compensation). 3-5 years of experience in Utilization Review applying screening guidelines (InterQual or MCG Guidelines) or...

Superior HealthPlanLaredo, TX

2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting....

CenteneAbilene, TX

2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting....

MSG Staffing, IncSacramento, CA

Working knowledge of the utilization review process, medical bill review and/or medical case management. Case Management in an insurance setting:....

Staffing as a MissionEl Paso, TX

Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual® or other...

Arkansas Blue Cross and Blue ShieldLittle Rock, AR

Adhere to URAC Management Standards. Contact member and physician explaining case management services, ensuring that all parties involved agree to voluntary...

Evangelical Community HospitalLewisburg, PA

Previous experience in Care Management/Utilization Management preferred. Work requires interpersonal skills to communicate with team members, clinical staff,...

Amber PharmacyOmaha, NE

Strong time management skills. 12.Assist with pharma requests for deliverables - i.e., capabilities presentations, data and utilization reports, etc....

Anonymous ConfidentialChatsworth, CA

Participate in Utilization Management and Quality Management Committees. Specific Clinical Therapist Duties*....

Sidney Care and RehabilitationSidney, NE

Experience with MDS completion, reimbursement, clinical resource utilization and/or case management is highly desirable....

Mercy Medical CenterSpringfield, MA

Work requires knowledge and skills in Occupational Health to perform direct patient care, internal/external referrals, Worker's compensation case management and...

OhioHealthColumbus, OH

The Clinical Database Informatist provides expertise to clinical quality and safety process improvement teams, oversight committees and senior leadership in the...

AP StaffingMassachusetts

Develop and implement a comprehensive Utilization Management plan for patients in an inpatient setting. Provide additional clinical information to insurance...

Lifetime CareRochester, NY

Performs other functions as assigned by management. Must demonstrate solid interpersonal, organizational and time management skills....

Life Care Centers of AmericaPost Falls, ID

Prior case management, utilization review, and discharge planning experience preferred. One (1) year of clinical experience in post-acute care setting preferred...

WakeMedRaleigh, NC

Oversight on all activities related to WakeMed's denials management, strategic pricing, and payment validation process....

Medical Staffing Network Care ManagementColumbia, SC

RN Medical Management Auditor Nurse Requirements:. The RN Medical Management Auditor Nurse is responsible for the auditing of corporate, health plan, and...


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