• Case Manager, Registered Nurse

    Sutter Health (San Francisco, CA)
    …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager, Medical Social Worker and bedside RN to assure ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
    Sutter Health (11/13/25)
    - Related Jobs
  • Mgr Corprate CDI

    Covenant Health Inc. (Knoxville, TN)
    …links with Integrity Office, Coding, Transcription, Quality Management, Case Management, Utilization Management, Physician Advisors and KBOS. Customer service ... documentation feedback on program objectives. + Works closely with KBOS, PAG Physician Advisors, Utilization Management, Quality Management and Coding personnel… more
    Covenant Health Inc. (10/13/25)
    - Related Jobs
  • Registered Nurse (RN) Navigator- Physician

    Bon Secours Mercy Health (Greenville, SC)
    …therapy and rehabilitation. As necessary, facilitates communication among patient/family, physician and interdisciplinary team through utilization of regular ... and rehabilitation following rescue in collaboration with the transplant physician , Mid-level practitioners and nursing staff. Provides psycho-social support to… more
    Bon Secours Mercy Health (12/23/25)
    - Related Jobs
  • Regional Payer Account Director - Central

    Lundbeck (Kansas, IL)
    …control mechanisms employed by MCO/PBMs and how they impact patients and physician 's utilization + Resourcefulness in getting access to decision makers, ... guidelines. **ESSENTIAL FUNCTIONS** + Engages in account portfolio planning using utilization data, and knowledge of therapeutic class management behavior by… more
    Lundbeck (11/14/25)
    - Related Jobs
  • Medical Director (Hybrid)

    CareFirst (Baltimore, MD)
    …**Experience:** 8 years clinical practice experience. **Preferred Qualifications:** + Experience in utilization management or served as physician advisor for ... & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review, care management and quality to determine the medical… more
    CareFirst (11/20/25)
    - Related Jobs
  • Care Progression Physician Advisor, ABSMC

    Sutter Health (Oakland, CA)
    …health care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical ... Sutter Health! **Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's leadership… more
    Sutter Health (12/17/25)
    - Related Jobs
  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the team to ... PHYSICIAN ADVISOR Department: CASE MGMT Job Summary The...correct level of care and reimbursement. Apply knowledge of utilization review, discharge planning, patient status changes, length of… more
    Mohawk Valley Health System (10/07/25)
    - Related Jobs
  • Practice Manager - Neurology

    Tufts Medicine (Boston, MA)
    …procedures for the scheduling of patient treatment visits for the most efficient utilization physician time, clinic space, and for efficient patient flow. 17. ... information, billing support, and co-pay collection procedures for the billing of all physician services as well as hospital charges in clinic(s). 4. Develops and… more
    Tufts Medicine (12/19/25)
    - Related Jobs
  • Director Care Management - RN

    Community Health Systems (Hattiesburg, MS)
    …and discharge planning. + Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. ... nursing experience required + 3-5 years of experience in care management or utilization review required + 1-3 years of leadership experience in a healthcare setting… more
    Community Health Systems (12/10/25)
    - Related Jobs
  • Pharmacy Tech II (US)

    Elevance Health (San Juan, PR)
    …to formulary and prescription benefits. + Generates reports relating to rebates, physician utilization , Beers Criteria, Reliance members, and other ad hoc ... reports. + Maintains record keeping of prior authorizations, rebates, and monthly reports. **Minimum Requirements:** + Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based… more
    Elevance Health (12/31/25)
    - Related Jobs