Utilization Review Jobs in Charleston, IL

The Manager Stars and Quality Improvement Programs plays a critical leadership role in advancing quality performance for the Medicare Advantage population with a specialized focus on medication-related quality measures. This includes driving improvements in Part D Star Ratings particu More...

The Manager Stars and Quality Improvement Programs plays a critical leadership role in advancing quality performance for the Medicare Advantage population with a specialized focus on medication-related quality measures. This includes driving improvements in Part D Star Ratings particu More...

Job Description SummaryThe Program Coordinator II is responsible for conducting all aspects of clinical drug and device trials; patient data; and disease registries for the Department of Surgery and the Department of Urology as directed by the Principal Investigator. This person will More...

Utilization Review PharmacistShape the drug benefit landscapeanalyze and optimize medication use.Key Responsibilities:Review prescribing trends and propose cost-saving alternatives.Maintain evidence-based formularies across multiple payers.Conduct retrospective DUR and prepare stakeho More...

Job Description SummaryThis position will serve as a Behavioral Health Coordinator for the MUSC Boeing Center for Childrens Wellness (BCCW). The Coordinator will support the integration of mental/behavioral health services in school districts supported by MUSC BCCW. Specifically the B More...

Job Description SummaryThe Clinical Trials Office (CTO) and Protocol Review and Monitoring System (PRMS) Program Manager within the Administration Operations Unit are recruiting for a Program Coordinator to join the team to provide administrative support in a National Cancer Institute More...

Job Description SummaryThe Stroke Research Program Coordinator provides clinical research support for the Stroke Research Center on the PCORI Funded TEAMS-BP trial. The Study Coordinator will be responsible for maintaining patient enrollment and screening logs assisting in specimen co More...

Job Description SummaryThe RN Nurse Auditor is a key member of the Clinical Appeals team and reports directly to the Clinical Appeals Manager. This role is responsible for conducting clinical reviews of payer audit determinations identifying improper denials and preparing detailed app More...

Job Responsibilities:The Citadel The Military College of South Carolina is accepting applicants for a Program Coordinator in the School of Humanities and Social Sciences (SHSS). In coordination with the Centralized Support Team the Program Coordinator will:Maintain and monitor multipl More...

Job Description SummaryThe College of Medicine Deans office is recruiting for a Student Services Program Coordinator.EntityMedical University of South Carolina (MUSC - Univ)Worker TypeEmployeeWorker Sub-TypeClassifiedCost CenterCC004733 COM DO UME Curriculum CCPay Rate TypeHourlyPay G More...

We are actively recruiting for an CAL RNs to join our rapidly growing Population Health team.  The primary role of the Care Manager will be to provide our patients with on-demand telephone-based care management services through a 24/7 Nurse Advice Line (i.e. telephone triage). &# More...

Anticipated End Date:Position Title:RN Utilization Management/Review Nurse InPatient MedicaidJob Description:RN Utilization Management/Review Nurse InPatient Medicaid (JR155056)Location: This position requires you to reside in the state of West Virginia.Virtual:This role enables ass More...

OverviewRecognized by Newsweek in 2024 and 2025 as one of Americas Greatest Workplaces for DiversityGrow your career with Brookdale! Our Clare Bridge Program Coordinators have opportunities for advancement by exploring a new career in positions such as Clare Bridge Program Managers Re More...

Job Description SummaryA program coordinator oversees programs and activities within the department ensuring efficiency and smooth workflow. They must also coordinate with different departments to gather and analyze data producing daily progress reports and documentation. Furthermore More...

Job Description SummaryThe Nurse Care Manager (Population Health) reports to the Director of Value Based Care Coordination. Under general supervision the Nurse Care Manager (Population Health) functions as a member of population health primary care outpatient focused teams. This role More...

We are actively recruiting for an CAL RNs to join our rapidly growing Population Health team.  The primary role of the Care Manager will be to provide our patients with ondemand telephonebased care management services through a 24/7 Nurse Advice Line (i.e. telephone triage). &#xa More...

CBS 13 in Charleston WV is looking for an experienced Capitol Reporter to cover state government for Nexstar stations statewide. This is your chance to be at the center of our political coverage while working in one of the best places to live in America. Candidates should be passionat More...

Regional Manager Quality Review for ID/DDGeorgia remote@Orchard LLC is supporting a notforprofit corporation that partners with public and private sectors to create highquality safe and efficient delivery of health care and human services programs. Our client has multiple lines of bu More...

Job Description SummaryUnder the direction of the Director of Enterprise Wellbeing Strategy and Operations. The Wellbeing Coordinator is responsible for the deployment and oversight of the Center for Workplace Wellbeings programs and initiatives specifically program management of the More...

At Amazon we believe that every day is still day one. We are working to be the most customercentric company on earth. To get there we need exceptionally talented bright and driven people. If youd like to help the Disability Leave Services (DLS) team build a bestinclass professional s More...