Utilization Review Jobs in USA

Registered Nurse Case Manager (RN)Schedule:Monday Friday 8:00am-5:00pmMake a Lasting Impact in Senior CareJoin Brigade Health Where Compassion and Clinical Excellence MeetWhy Senior Doc at Brigade HealthAt Senior Doc at Brigade Health we provide end-to-end senior care with a specialization in deme...

Employment Type:Full timeShift:Day ShiftDescription:Why MediGoldMediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. Were dedicated to providing excellent customer service cost-effective care and exceptional healthc...

AHCCCSArizona Health Care Cost Containment SystemAccountability Community Innovation Leadership Passion Quality Respect Courage TeamworkThe Arizona Health Care Cost Containment System (AHCCCS) Arizonas Medicaid agency is driven by its mission to deliver comprehensive cost-effective health care to Ar...

Innovation is at the core of what we do. We believe that by removing and reducing the barriers thatprevent people from taking their medications we can help customers conveniently get themedications they need when they need them and take them as prescribed. We have providedcustomers with the ability...

Embark on a purpose-driven journey as a Registered Nurse Case Management specialist in Everett Washington where your expertise guides patients through complex care landscapes and helps families navigate transitions with confidence. This travel-ready opportunity puts you at the he...

Full-timeDescriptionClinical Director - SteamboatReports to: Chief Clinical OfficerJob Category: Salaried Exempt Full-TimeSalary Range: $85000-$125000/yearJob Site: Foundry - Ranch Steamboat SpringsWork Schedule: Sunday-Thursday or Tuesday-Saturday; 9am-5pmJob Summary:The Clinical Director overse...

Hours:Shift Start Time:8 AMShift End Time:5 PMAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$33.400 - $41.740 - $46.760The stated pay scale reflects the range that Sharp reasonabl...

JOB DEFINITION:Work with the CN Guidance Youth ACT Team to deliver services to youth who are diagnosed with severe emotional disturbance (SED) and their identified families whose needs have not been met by more traditional service delivery approaches. EDUCATIONAL REQUIREMENTS:Masters degree in Soci...

DescriptionJob SummaryThe Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the supervision of a Registered Nurse or physician. This role involves reviewing medical records for appropriateness and necessity collaborating...

DescriptionWhy Northwest HealthWe know its not just about finding a job. Its about finding a place where you are respected valued and where your work is purposeful and fulfilling. A place where your talent is recognized professional development is encouraged and career advancement is possible.Team m...

Weve made a lot of progress since opening the doors in 1942 but one thing has never changed - our commitment to serve heal lead educate that every award earned every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner whether you work with...

Anticipated End Date:Position Title:RN Medical Management Clinician Sr.Job Description:Medical Management Clinician Sr.LOCATION: This is a virtual eligible position. Virginia residency is required.HOURS: General business hours Monday through Friday.This role enables associates to work virtually full...

MinUSD $29.44/Hr.MaxUSD $45.64/Hr.OverviewJoin Memorial Health and make a real difference in the lives of patients and their families. As a PRN Counselor (LSW) with an MSW degree youll play a critical role in addressing complex psychosocial factors that affect health outcomes contributing to holisti...

MinUSD $29.44/Hr.MaxUSD $45.64/Hr.OverviewJoin Memorial Health and make a real difference in the lives of patients and their families. As a PRN Counselor (LSW) with an MSW degree youll play a critical role in addressing complex psychosocial factors that affect health outcomes contributing to holisti...

OverviewBaylor Scott & White Institutefor RehabilitationJoint venture with Select MedicalFort Worth TXInpatient RehabilitationProspective Payment System (PPS) ManagerIRF-PAI CoordinatorFull-timeOur Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best...

Overall PurposeThe Medical Director Utilization Management serves as the physician leader responsible for medical oversight of the Utilization Management (UM) program at P3 Health Partners. This role ensures the quality safety effectiveness and efficiency of utilization review processes including pr...