• Pharmacist - Inpatient, Medical Reconciliation

    Carle Health (Urbana, IL)
    Management Services as defined in the Illinois Pharmacy Practice Act. Performs utilization management reviews. Serves as drug information resource for other ... departments. Conduct medication reconciliation, perform clinical interventions, uncover adverse drug reactions, and refer patients to pertinent clinics (ie anticoagulation). About Us **Find it here.** Discover the job, the career, the purpose you were meant… more
    Carle Health (12/17/25)
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  • ECR Dispute Reviewer

    Zelis (St. Petersburg, FL)
    …experience in a healthcare setting, with a strong background in clinical review, utilization management , or quality assurance. + Extensive knowledge of clinical ... present reports on clinical review outcomes, trends, and performance metrics to management and other stakeholders. + Contribute to the development of clinical review… more
    Zelis (12/17/25)
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  • Pharmacy Technologist, Sr - Huntsville Central…

    UTMB Health (Huntsville, TX)
    …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... medications + Participates in the operations of medication therapy management + Initiates medication reconciliation + Assists with screening, documentation,… more
    UTMB Health (12/16/25)
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  • Physician

    Spira Care, LLC (Kansas City, KS)
    …Medical Policies re: coverage and medical necessity + participation in key utilization management activities (ex: peer-to-peer consultations with health plan ... practices. + Clear, complete, and timely clinical documentation in EMR per risk management and Spira Care policy. + Participation in activities aligned to reducing… more
    Spira Care, LLC (12/16/25)
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  • RN Case Manager - Progress West Hospital

    BJC HealthCare (O'Fallon, MO)
    …to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to ... Holiday rotation **Additional Preferred Requirements** + BSN + Prior Case Management experience + Computer/typing skills **Overview** Opened in 2007, **Progress West… more
    BJC HealthCare (12/14/25)
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  • Home Health Weekend Nurse - Beaver and Allegheny…

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to ensure appropriate, quality patient care. +… more
    UPMC (12/13/25)
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  • Professional Staff Nurse - Home Health OB/Peds…

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to ensure appropriate, quality patient care. +… more
    UPMC (12/13/25)
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  • Mental Health Nurse - Home Health Allegheny County

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to ensure appropriate, quality patient care. +… more
    UPMC (12/13/25)
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  • Occupational Therapist, Home Health

    Sutter Health (Alameda, CA)
    …of care within an interdisciplinary team and participating in effective utilization management and control of patient supplies. Consistently provides ... manner. + Excellent collaborative and problem solving skills with customers and management . + Ability to exercise independent sound judgment in planning and… more
    Sutter Health (12/12/25)
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  • Home Health Admissions Nurse McKnight

    UPMC (Seven Fields, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... patients' needs. + RN will coordinate case management activities across a multi-disciplinary health care team to ensure appropriate, quality patient care. +… more
    UPMC (12/12/25)
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