• Social Worker (Program Coordinator)

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …similar role or with population served Clinical supervision certification Quality or utilization management experience Former VA Trainee Reference: For more ... information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The actual grade at which an applicant may be selected for this vacancy is GS-12. Physical Requirements: Moderate lifting/carrying 15-45 pounds, reaching… more
    Veterans Affairs, Veterans Health Administration (12/18/25)
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  • Occupational Therapist - Inpatient

    Stanford Health Care (Palo Alto, CA)
    …area + Knowledge of basic business aspects of position, such as utilization management , charging practices and regulatory practice compliance; + Knowledge ... of evaluation and treatment methodologies as applied to routine patient care + Knowledge of legal issues affecting the clinical practice + Knowledge of pathologies and injuries which result in physical, cognitive and other functional impairments + Knowledge of… more
    Stanford Health Care (12/18/25)
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  • Senior Health Economist - Managed Care

    Elevance Health (Wallingford, CT)
    …Capabilities, and Experiences:** + Actuarial sciences background highly preferred. + Utilization Management experience preferred. + Medical economics, provider ... finance, healthcare analytics, and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with SQL, SQL Server, Teradata, or equivalent strongly preferred. + Proven ability to design… more
    Elevance Health (12/17/25)
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  • Pharmacy Clinical Review Specialist- Hybrid I HPL

    UPMC (Pittsburgh, PA)
    …coordination of benefits, complaints and grievance guidelines and prescription drug utilization management requirements. + Thorough knowledge in MS Office ... and PC skills required. + Organizational, analytical, interpersonal, and communication skills. + Ability to prioritize and perform multiple tasks while maintaining designated production and quality standards. + Staff is required to work scheduled overtime and… more
    UPMC (12/12/25)
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  • Physical Therapist, Physical Therapy - Full-Time…

    Queen's Health System (Kaunakakai, HI)
    …person and facilitator of hospital-wide and Medical Staff Performance Improvement (PI), Utilization Management (UM), Infection Control (IC) and Employee Health. ... **TYPICAL PHYSICAL DEMANDS** Essential: Seeing, hearing, speaking, standing, walking, stooping/bending, kneeling, twisting body, finger dexterity, lifting weight up to 75 pounds, pushing/pulling weight up to 200 pounds, carrying weight up to 75 pounds,… more
    Queen's Health System (12/09/25)
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  • Registered Nurse - Surgical Services (Big Island,…

    Queen's Health System (Kamuela, HI)
    …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. **II. TYPICAL PHYSICAL DEMANDS:** * ... Essential: lifting up to 2 lb., seeing, hearing, talking, grasping, fingering, standing, walking, stooping, forward reaching, handling. * Frequent: pushing and pulling up to 30 psi, lifting up to 10 lbs., sitting, bending, squatting, twisting. * Occasional:… more
    Queen's Health System (12/09/25)
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  • Pharmacy Clinical Review Specialist, Rx Partners

    UPMC (Bridgeville, PA)
    …coordination of benefits, complaints and grievance guidelines and prescription drug utilization management required + Thorough knowledge in MS Office ... and PC skills required. + Customer Service experience with communication via telephone, e-mail and face to face required. + Knowledge of electronic claims adjudication and resolution required + Experience with prioritizing and multitasking requiredLicensure,… more
    UPMC (12/08/25)
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  • Physician - Rehabilitation & Extended Care…

    Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
    …practitioners/physician assistants in the CLC. Quality Assessment/ Quality Improvement/ Utilization Management activities including, improving clinical ... performance of medical services, infection control, identifying hazards to the health and safety of patients and staff. Also provides education to staff across the service for continuing education. Ensures policy, procedure and guidelines are followed per VHA… more
    Veterans Affairs, Veterans Health Administration (12/06/25)
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  • RN, Clinical Document Spec

    University of Rochester (Rochester, NY)
    …Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States of America) ... Range: UR URCE 215 Compensation Range: $81,310.00 - $105,703.00 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be… more
    University of Rochester (12/05/25)
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  • PT Registration Spec - ED

    Covenant Health Inc. (Knoxville, TN)
    …through the Emergency Department for the Advanced Care at Home program and Utilization Management . + Rotates on-call and holiday schedule to meet departmental ... demands in the 24/7 environment. + Assists acute nursing floors with a variety of tasks (ie assignment of beds, PIN corrections, printing of labels and canceling discharges). + Provides assistance to visitors presenting through the Emergency Room Entrance. +… more
    Covenant Health Inc. (12/05/25)
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