• RN - Resource Management Nurse Reviewer

    Trinity Health (Davenport, IA)
    …of medical necessity for appropriate level of care and ensure benefit utilization to maximize reimbursement + Provides education to healthcare personnel and ... physicians relative to care status, resource utilization , documentaion requirements, optimization opportunities, and appropriate levels of care + Key… more
    Trinity Health (01/16/26)
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  • RN Bed Management Coordinator - (Full-time, Day)

    Virtua Health (Pennsauken, NJ)
    …than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, ... the hospital system by coordinating bed assignments, ensuring efficient utilization of resources, and supporting patient admission, transfer, and discharge… more
    Virtua Health (01/15/26)
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  • Medical Reviewer LPN

    Health Care Service Corporation (Nashville, TN)
    …reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care. **JOB REQUIREMENTS** **:** + LPN with ... in the state of operations. + 3 years of clinical experience in physician office, hospital, or surgical setting. + Customer service oriented to assist… more
    Health Care Service Corporation (01/14/26)
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  • Account Manager, Endovascular

    Abbott (Pensacola, FL)
    …includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management, market ... on clinical differentiation in the procedure, value proposition, product launch, physician onboarding, early case coverage and training. + Influence stakeholders… more
    Abbott (01/14/26)
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  • Case Manager

    AnMed Health (Anderson, SC)
    …support, transitions in care, resource connection, and appropriate resource utilization . Duties & Responsibilities + Works collaboratively and maintains active ... of the healthcare team on the achievement of optimal outcomes, resource utilization , clinical expertise, and improvement strategies. + Supports efficient resource … more
    AnMed Health (01/14/26)
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  • Social Complex Care Manager, SW

    ChenMed (Greenacres, FL)
    …of social wellness tools for the care team's awareness and utilization .Communication. + Maintains communication with other healthcare team members by attending ... with challenged caregivers/family systems of high-risk patients + Appropriate utilization of community-based resources + Teamwork skills in care coordination… more
    ChenMed (01/13/26)
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  • Senior Analyst, Medical Economics - REMOTE

    Molina Healthcare (Cleveland, OH)
    …to medical care costs. * Analyzes the financial performance, including cost, utilization and revenue of all Molina products - identifying favorable and unfavorable ... medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Proficiency with retrieving… more
    Molina Healthcare (01/11/26)
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  • Vaccines Account Manager

    Pfizer (Augusta, ME)
    …and ensure the implementation of the appropriate tactics to maximize utilization of Pfizer Vaccines, decrease disparities, and improve overall immunization rates. ... KPIs include, but are not limited to, vaccine portfolio utilization , Health IT / protocol development, contract closure and...the Sunshine Act. Therefore, if you are a licensed physician who incurs recruiting expenses as a result of… more
    Pfizer (01/08/26)
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  • RN Case Manager , Casual

    Trinity Health (Westerville, OH)
    …or discharge. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses for patients, providing ... customer support to our internal and external customers, appropriate utilization of resources and patient advocacy. **Responsibilities** + Identifies discharge… more
    Trinity Health (01/08/26)
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  • Care Manager RN - Case Management - Part time Day…

    Providence (Santa Rosa, CA)
    …staff, medical center personnel and outside resources to ensure the appropriate utilization of resources according to clinical and financial standards. Monitors the ... with management, medical staff and medical center personnel. Provides payor/ utilization review organizations with concurrent retrospective utilization review… more
    Providence (01/08/26)
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