• Referral Clerk

    Katmai (Fort Carson, CO)
    …and providers, network/outside providers and ancillary healthcare workers. + Apply principles of utilization review (UR) and utilization management (UM) in ... MTF Referral Management Centers) in processing referrals to specialty care . **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review ...Identify cases that may benefit from alternative levels of care and involve the case manager as… more
    Katmai (11/26/25)
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  • Respiratory Specalist

    Bassett Healthcare (Oneonta, NY)
    …as a resource for the Respiratory Care Department in absence of supervisor, manager and director + Assists in full utilization of staff working time, based ... What you'll do Under general supervision by the Supervisor, Manager , and Director of Respiratory Care Services...of respiratory therapy. (Measured by student assessments and leadership review ) + Therapy recommendations for patient care .… more
    Bassett Healthcare (10/29/25)
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  • Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    care manager 's supervisor, as needed, at the time of the annual performance review + Non- care manager support staff duties may include: + Requesting ... Utilization Management, Behavioral Health, Quality Management, or Member Care Management. This position acts as a resource for...to non- care managers are monitored by the care manager + The care more
    Excellus BlueCross BlueShield (10/21/25)
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  • Registered Nurse I, Acute RCIS

    Bassett Healthcare (Cooperstown, NY)
    …than 2-3 exceptions, as measured by direct supervisory observation and random supervisory chart review + Directs and supervises patient care provided by LPNs and ... than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. +...other duties as requested and observed by supervisor or manager . + RN I Acute Care Certification… more
    Bassett Healthcare (12/11/25)
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  • Nurse I - RN Critical Incident/Occurrence…

    State of Colorado (Pueblo, CO)
    …understood, actionable, and tied to CMHHIP's improvement goals. + Participate in utilization management and review activities when requested, applying clinical ... partner. CMHHIP is a 24 hour behavioral health acute care facility that is intended to provide a safe,...reportable occurrence, this position makes recommendations to the Occurrence Manager for referral to a CMHHIP department or specific… more
    State of Colorado (12/03/25)
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  • RN Structural Heart (TAVR) Coordinator - Full Time…

    University of Southern California (Arcadia, CA)
    …outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains ... professional and patient care interactions.* Performs other duties as assigned by Manager / Director / Clinical Lead RN.* Prioritizes cases to provide service to… more
    University of Southern California (12/11/25)
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  • Senior Clinical Nurse Specialist Medical Asset…

    Immigration and Customs Enforcement (Washington, DC)
    …supports nursing staff, advances nursing practices, and contributes to the IHSC Health Care Mission. Their duties include providing direct patient care at ... Unit to implement initiatives aimed at enhancing clinical nursing care across IHSC. This position is only open to...Services Unit. c. May be utilized as acting Nurse Manager (NM) during TDY assignments and may be providing… more
    Immigration and Customs Enforcement (11/06/25)
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  • Epidemiologist III

    MyFlorida (Orlando, FL)
    …and response infection prevention and control assessments as needed, including a review of health care facilities infection prevention plans, direct observation ... to Healthcare-Associated Infections (HAI)/Antimicrobial Resistant (AR) organisms to support health care facilities and the Florida Department of Health in Orange… more
    MyFlorida (12/18/25)
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  • Network/Provider Rep.

    ChenMed (Clearwater, FL)
    …Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization . This individual will work closely with and consider feedback ... Specialty, MED COE and HCT leaders to support improved medical costs and specialty care utilization . This individual will work closely with and consider feedback… more
    ChenMed (12/25/25)
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  • Market CMO - South Carolina

    CenterWell (Columbia, SC)
    …medical guidance and expertise. . Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the quality and ... community and help us put health first** The Market CMO serves as a health- care professional and capable of handling a variety of health-related problems. The Market… more
    CenterWell (11/28/25)
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