• RN Utilization Management - Full-Time TRACK…

    Trinity Health (Albany, NY)
    …Hospital--Full-TIme TRACK weekends** If you are looking for an RN position in Case Management and a regular Monday-Friday schedule is your preference, this ... utilization management process + Working knowledge of recognized industry clinical standards, ie Interqual, Milliman Care Guidelines. + Maintain the highest… more
    Trinity Health (09/12/25)
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  • Sr Utilization Review Specialist Nurse

    Houston Methodist (Houston, TX)
    …years of hospital clinical nursing experience, which includes five years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered ... Physician Advisor to address identified educational needs for providers and utilization review/ case management team members. + Serves as the primary information… more
    Houston Methodist (08/26/25)
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  • VP, Healthcare Services ( Work Location:…

    Molina Healthcare (Covington, KY)
    management of the state health plan's Healthcare Services ( clinical operations) teams including Utilization Management (prior-authorization, inpatient ... review) and Care Management ( case /health management and transition of care). This...management team to achieve successful implementation of Molina clinical strategy and direction. + Develops and implements effective… more
    Molina Healthcare (08/31/25)
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  • Prior Authorization Team Lead Coordinator

    Fallon Health (Worcester, MA)
    …submits reports assigned by the Manager + Refers to high-risk cases to the Case Management Department, Government Services Clinical Programs, Fallon Clinic ... policies and standards. **Responsibilities** **Primary Job Responsibilities:** + Follows the Case Management Standards of Practice, Ethical standards, department… more
    Fallon Health (09/25/25)
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  • Social Work Specialist/LMSW (Hybrid - Troy,…

    Henry Ford Health System (Troy, MI)
    …member data and assist with measuring outcomes. + Ensures and enters documentation of social work case management activities in a timely manner and in ... GENERAL SUMMARY: The Social Work Specialist supports and maintains the psychosocial health...record. + Assist and counsels members enrolled in a Case Management program with health related financial,… more
    Henry Ford Health System (09/20/25)
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  • Social Worker (PRN) - Care Management

    Trinity Health (Silver Spring, MD)
    …**Position Purpose:** Social Workers will perform beside initial and ongoing case management assessments, counseling, referral and discharge planning services ... the inpatient setting back to the community. + Review clinical supporting documentation to support the throughput of all...licensure (or license eligible). + Masters Degree in Social Work . + Previous social work experience in… more
    Trinity Health (09/17/25)
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  • Master Social Worker Care Coordination

    Banner Health (Phoenix, AZ)
    **Primary City/State:** Phoenix, Arizona **Department Name:** Case Mgmt-Hosp ** Work Shift:** Day **Job Category:** Clinical Care Find your path in health ... regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts… more
    Banner Health (08/30/25)
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  • Senior Social Worker - Health Care for Homeless…

    Veterans Affairs, Veterans Health Administration (Jackson, MS)
    …with veteran to develop an initial plan of care; Providing advanced level case management ; Providing crisis intervention services. Provides case ... family counseling or psychotherapy and advanced level psychosocial and/or case management . Ability to incorporate complex multiple...delivery area, as well as role modeling effective social work practice skills. Ability to expand clinical more
    Veterans Affairs, Veterans Health Administration (09/17/25)
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  • Utilization Management RN

    Grace Hospital (Morganton, NC)
    Blue Ridge HealthCare Hospitals - Morganton Clinical Case Management THE ORGANIZATION At UNC Health Blue Ridge, we live our mission by enhancing the lives of ... because: + We are a teaching hospital + We work together to ensure our patients receive outstanding, holistic...POSITION Join our dynamic healthcare team as a Utilization Management RN, where you will play a vital role… more
    Grace Hospital (09/06/25)
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  • Therapist-BSW/LSW-Ycats

    Premier Health (Dayton, OH)
    …The therapist will provide individual and family therapy services, and some limited case management to young children. Other services to be provided may ... and families or a strong desire to learn to work with young children and families. The YCATS therapist...and reporting of outcome measures and documentation of utilization management of clinical care. Demonstrate knowledge of… more
    Premier Health (07/03/25)
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