- Commonwealth Care Alliance (Boston, MA)
- …with the VP of UM to direct the efforts of the utilization review and pre-certification functions to accomplish objectives within policy and budget. + Serve as a ... the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will...on a weekly basis + Provide education to internal care management and clinician staff + Provide… more
- US Tech Solutions (Chicago, IL)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. +… more
- US Tech Solutions (May, OK)
- …. MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. .… more
- Elevance Health (NV)
- Position specific details: The successful candidate will be an independently licensed clinician residing and licensed in Nevada. **Work Hours: 8am-5pm PST** **Work ... and ensures essential face-to-face onboarding and skill development. The **Behavioral Health Care Manager II - Nevada** is responsible for managing psychiatric and… more
- Humana (Frankfort, KY)
- …key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ million ... and partnering across the enterprise (eg, with Clinical Operations, Markets, Care Management, Analytics, Pharmacy, etc.) to develop discrete, high-value strategies… more
- University of Michigan (Ann Arbor, MI)
- …patients, populations and communities through excellence in education, patient care , community service, research and technology development, and through leadership ... guided by our Strategic Principles and has three critical components; patient care , education and research that together enhance our contribution to society. **Why… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... an Assistant Professor of Clinical in Pediatric Adolescent Gynecology on the Clinician Educator track will have clinical responsibilities within the Department of… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- University of Miami (Miami, FL)
- …pediatrics units, students and residents are active participants in our multidisciplinary care . Our faculty are highly dedicated clinician educators committed to ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Academic Pediatric Hospitalist… more
- University of Michigan (Ann Arbor, MI)
- …Registered Dietitian Nutritionist (RDN); the RDN will cover neonatal intensive care unit. This position will perform nutrition assessments and develop nutrition ... care plans using the Academy of Nutrition and Dietetics...+ Certified Diabetes Educator (CDE) + Certified Nutrition Support Clinician (CNSC) + Certified Specialist in Oncology Nutrition (CSO)… more
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