• Lead Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …At least 8 years of clinical appeals and grievances experience in a managed care, utilization management and/or case management setting, At least 2 years in ... training, and feedback on performance to department management . Work closely with management to review performance and quality standards on an ongoing basis.… more
    LA Care Health Plan (11/11/25)
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  • Primary Care Physician

    STG International (Yellowstone National Park, WY)
    …in quality improvement, care management , risk management , peer review , utilization review , clinical outcomes, and health enhancement activates. ... after hire. Participate in the orientation of physician assistants and nurse practitioners. * Provide leadership to Yellowstone's Mammoth Clinic providers and… more
    STG International (11/07/25)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Dallas, TX)
    …clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. The Clinical Rehabilitation Specialist works ... closely with hospital case management to ensure a responsive and smooth flowing referral...prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong clinical… more
    HCA Healthcare (09/27/25)
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  • Assistant/Associate Professor, Clinical Faculty…

    MD Anderson Cancer Center (Houston, TX)
    …and 2% Education. The faculty member is responsible for clinical expertise in the management of the critically ill cancer patient in the ICU and in providing ... policy. Will require dictating in a clear and concise manner, and visual review of documents. Correspond as appropriate, in writing or by telephone, to conversations… more
    MD Anderson Cancer Center (11/12/25)
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  • Pediatrician / Family Practice

    KidsPeace Childrens Hospital (Schnecksville, PA)
    …and/or services based on the needs of the organization; + Participating in utilization review activities including but not limited to development of standards, ... history and physical examination, either written or dictated. This includes a review of the immunization status, allergies, past history, family history and… more
    KidsPeace Childrens Hospital (10/07/25)
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  • LVN, On-Call

    MTC (Littlefield, TX)
    …clean; utilize appropriate sanitation methods. 17. Practice basic cost containment and utilization management for patient care and facility operations. 18. ... who values helping people turn their lives around.** At Management & Training Corporation, our foundation is based upon...on an individual or group basis, as required. 12. Review and process all reports and documents in a… more
    MTC (11/14/25)
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  • Case Manager RN PRN

    HCA Healthcare (Portsmouth, NH)
    …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... **Job Summary and Qualifications** **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more
    HCA Healthcare (11/10/25)
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  • RN Case Manager

    HCA Healthcare (Portsmouth, NH)
    …throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and observation ... opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating the… more
    HCA Healthcare (11/10/25)
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  • Primary Care Physician - Spanish Speaking…

    ChenMed (Berwyn, IL)
    …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required that promote… more
    ChenMed (09/04/25)
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  • RN Plan Case Manager Atlanta

    PruittHealth (Atlanta, GA)
    …Minimum three years industry experience in a managed care setting focused on experience in utilization review /case management and at least two years case ... **JOB PURPOSE:** Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible… more
    PruittHealth (11/19/25)
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