• 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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  • Field Reimbursement Manager, Ft. Lauderdale, FL…

    Sanofi Group (Fort Lauderdale, FL)
    …on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for Dupixent + Establish positive and productive ... working relationships with all key customer segments (internal and external) + Partner with Alliance colleagues to create a culture of respect and customer focus + Develop working relationships with state societies, associations and advocacy groups, as needed,… more
    Sanofi Group (12/05/25)
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  • Adult Therapist

    Monte Nido (Winfield, IL)
    …continuity of care. + Collaborate with insurance companies for pre-certification and utilization management . + Contribute to discharge and aftercare planning to ... support clients' ongoing recovery. + Facilitate therapeutic meal support by modeling a healthy relationship with food, guiding clients through exposures, and helping them build confidence in challenging eating situations. + Implement exposure therapy… more
    Monte Nido (12/04/25)
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  • Primary Therapist

    Monte Nido (Parsippany, NJ)
    …and outpatient providers + Interact with insurance companies for pre-certification and utilization management + Participating in discharge and aftercare planning ... + Therapeutic meal support, while modeling a healthy relationship with food + Provides safe, empathetic, and affirming care for each client and their unique circumstance based on the clients' intersecting identities Qualifications: + Master's degree in… more
    Monte Nido (12/04/25)
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  • Primary Therapist

    Monte Nido (Wickenburg, AZ)
    …and outpatient providers + Interact with insurance companies for pre-certification and utilization management + Participating in discharge and aftercare planning ... + Therapeutic meal support, while modeling a healthy relationship with food + Provides safe, empathetic, and affirming care for each client and their unique circumstance based on the clients' intersecting identities Qualifications: + Master's degree in… more
    Monte Nido (12/04/25)
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  • Occupational Therapist (OT) - Relief Status

    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 impairments + Knowledge of principles, methods, equipment… more
    Stanford Health Care (12/02/25)
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  • Primary Therapist

    Monte Nido (Tempe, AZ)
    …and outpatient providers + Interact with insurance companies for pre-certification and utilization management + Participating in discharge and aftercare planning ... + Therapeutic meal support, while modeling a healthy relationship with food + Provides safe, empathetic, and affirming care for each client and their unique circumstance based on the clients' intersecting identities Qualifications: + Master's degree in… more
    Monte Nido (11/27/25)
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