• Clinical Appeals and Disputes Nurse

    University of Washington (Seattle, WA)
    … review (or utilization management or healthcare management ), certified case manager , certified documentation specialist, certified coder, certified ... professional medical auditor + Previous experience working as an RN + Extensive knowledge of ICD-10-PCS, ICD-10-CM, CPT and HCPCS coding principles and guidelines +… more
    University of Washington (12/19/25)
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  • Assoc Business Analyst - Credit Back Office

    Exelon (Philadelphia, PA)
    …and written communications skills and basic analytical, problem solving and project management skills. + Knowledge of the practices, procedures and principles ... analysis. Monitor and coordinate activities to support operational performance management (eg, safety, reliability, service level, productivity, etc.). Track,… more
    Exelon (01/14/26)
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  • Medical Director - Medical Oncology

    Elevance Health (Miami, FL)
    …and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in work groups ... **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually… more
    Elevance Health (12/04/25)
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  • Operating Room Nurse Clinician IV (RN) - CLC

    UTMB Health (Webster, TX)
    …as evidenced by advanced degree, certification in specialty care area, utilization /dissemination of evidence-based resources, etc. + Demonstrates knowledge and ... Clinician IV (RN) - CLC **Webster, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2507149 **REQUIRED EDUCATION & EXPERIENCE:** RN with… more
    UTMB Health (12/20/25)
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  • Director Care Transition

    Texas Health Resources (Arlington, TX)
    …Certified Case Manager Upon Hire Preferred Or CPUM - Certified Professional Utilization Manager Upon Hire Preferred Or Other ANCC Upon Hire Preferred Skills ... necessary for a high-performance culture related to care transition management . Utilizes change management techniques to facilitate...Hire Required And ACM - Accredited Case Manager Upon Hire Preferred Or CCM -… more
    Texas Health Resources (01/06/26)
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  • Special Ops Licensed Clinical Social Worker (NAB,…

    KBR (San Diego, CA)
    …product/service agreements to ensure mutual compliance in meeting care goals. * Knowledge and skill in using pre-established utilization review criteria ... We are seeking a stellar Special Operations Nurse Case Manager that will provide a full range of professional... Certification or American Nurse Credentialing Center. * Demonstrated knowledge of patient education principles and management … more
    KBR (11/25/25)
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  • Employer Health Consultant

    WellSpan Health (Lewisburg, PA)
    …state of residence. Driving record must meet requirements established by WellSpan Risk Management . ** Knowledge , Skills, and Abilities:** + Knowledge in ... partnerships and achieves sales targets, while serving as the primary account manager to deliver sustained value, foster loyalty, and identify opportunities for… more
    WellSpan Health (01/10/26)
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  • Telephonic Pharmacist

    Actalent (Atlanta, GA)
    …(PLUS++) + Prior authorization experience + Experience working in a Pharmacy Benefit Manager (PBM) environment + Medication Therapy Management (MTM) experience + ... Description Overview: Under supervision of a Clinical Pharmacy Assistant Manager as designated, supports Formulary adherence by providing consistent medication… more
    Actalent (01/10/26)
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  • Account Executive

    ThermoFisher Scientific (Cincinnati, OH)
    …The Life: + Develops and implements the strategy and tactics to increase test utilization and test menu, effectively presenting the value of our testing to key ... individuals within target organizations, including top executives and laboratory management . + Grows oncology and special protein market share...placement). You will work closely with the Area Sales Manager and Key Account Manager to ensure… more
    ThermoFisher Scientific (12/13/25)
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  • Senior Enterprise Systems Analyst

    Clark County, NV (Las Vegas, NV)
    … (HCM) modules including Time Management , Payroll, Benefits, Organizational Management , Personnel Administration, Employee Self Service, or Manager Self ... continuous improvement initiatives, and directing staff utilizing established project management methodologies. Also, this position will participate in configuration,… more
    Clark County, NV (11/12/25)
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