Utilization Review Jobs in USA

Anticipated End Date:Position Title:Clinical Pharmacist Clinical Pharmacy Strategy Team - CarelonRxJob Description:Clinical Pharmacist Clinical Pharmacy Strategy Team - CarelonRxLocations: GA-ATLANTA 740 W PEACHTREE ST NWIN-INDIANAPOLIS 220 VIRGINIA AVEKY-LOUISVILLE 3195 TERRA CROSSINGS BLVD STE 203...

Employment Status:Full timeShift:Day/Evening (United States of America)Facility:4348 Electric Rd - RoanokeRequisition Number:R158990 LPN Care Coordinator - Pediatric Nephrology (Open) How Youll Help Transform Healthcare:The LPN Care Coordinator provides care management for specific patient...

SummaryWe are currently hiring for a Managed Care Coordinator II Utilization Management to join BlueCross BlueShield of South this role as a Managed Care Coordinator II Utilization Management you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria b...

The following Military Occupational Specialty codes are generally applicable to this position. Applicants must fully complete the summary of experience to determine if minimum qualifications are met.Military Crosswalk Guide - Prepared by the State Auditors OfficeI. JOB SUMMARYPerforms complex admini...

The following Military Occupational Specialty codes are generally applicable to this position. Applicants must fully complete the summary of experience to determine if minimum qualifications are met.Military Crosswalk Guide - Prepared by the State Auditors OfficeIII. MINIMUM QUALIFICATIONSA. Educati...

DescriptionAssessment SupervisorSchedule: Full-timeYour experience mattersTriangle Springs is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to...

Occupational Therapist Duties include Effectively screens/evaluates patients and/ with cognitive and/or ADL physical functioning disorders and develops appropriate plan of care following all regulatory and clinical practice standards. Utilizes standardized assessments and evidence-based practice t...

Job Summary: The Medical Coder is responsible for accurately assigning ICD10CM CPT and HCPCS codes to inpatient swing bed outpatient emergency and ancillary services in accordance with federal regulations payer guidelines and Critical Access Hospital billing requirements. This role ensures complete...

This position needs are 12-hour night shift every 3 weekend and one shift during the week.The Quality Utilization Specialist - PNE reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedu...

 We are seeking a Clinical Care Manager who is passionate about advancing highquality compliant patientcentered care through precise and timely Utilization this role you will apply clinical expertise and regulatory knowledge to evaluate healthcare services ensure medically necessary care support pr...

Position Summary: The Nurse Case Manager assists in providing a system of health care delivery at UMC which utilizes a coordinated collaborative multi-disciplinary approach to assess plan coordinate and evaluate the health care needs of patients throughout the health care continuum. The Nurse Case M...

Discover Your Career at Emory UniversityEmory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community.DescriptionThe...

GRADE 18 LOCATION OF POSITION MDH Office of the Assistant Secretary for Population Health & Strategic Initiatives201 W. Preston StreetBaltimore MD 21201Main Purpose of Job The main purpose of this full-time contractual position will be to lead and execute the States strategic initiatives...

Location:Windsor Run by Erickson Senior LivingJoin our team as a Program Coordinator (Continuing Care) to support the delivery of engaging therapeutic programming that enhances the lives of residents across our Continuing Care neighborhoods including Assisted Living Memory Care Skilled Nursing and L...

Open: March 18 2026 Close: April 2 2026 Job Title: Program Coordinator Department: Emergency Housing Repair Reports To: Director Hours: 40 Hrs/Wk Full TimeSalary: Based on Salary MatrixBenefits Requisition: 887 *Salaries are market competitive. For accurate salary information call or...

Job DescriptionHarborview Medical Center - Stroke Center has an outstanding opportunity for a Full-time Days Stroke Program Coordinator.WORK SCHEDULEFull-time 100% FTE (40 hours per week)Monday- FridayDay Shift 0800-430pmNo telework/On-sitePOSITION HIGHLIGHTSConveniently located near public transpor...

DescriptionAt Bristol Health we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients residents and families. We are committed to provide compassionate qua...

DescriptionDo you like being responsible for residential and community programs Do you emjoy setting departmental goals leading staff and holding them accountable Do you enjoy working and coordinating with a multi-disciplinary teamIf you answered YES to either of these questions then consider joinin...

DescriptionJob SummaryThis role supports care coordination activities within ambulatory services specifically for the medical group. Performs all duties as assigned.Job Responsibilities Collaborate in overseeing the practices care coordination initiatives. Assist with and facilitate the...

Background Screening Information - Position SummaryThe Care Manager Assistant - LPN assists with the coordination of the patients care and services. Promotes quality care using a collaborative process that coordinates monitors and evaluates services according to the needs of and interpersonal contac...