• Sr. Client Success Manager

    CirrusMD (Denver, CO)
    …CirrusMD's integrated care spans multiple specialties-from acute and chronic care to behavioral health. Our platform serves 10 million users across all 50 states ... growth by identifying upsell opportunities, growing membership/employee lives, and meeting utilization goals. What You'll Do + Responsible for growing and retaining… more
    CirrusMD (09/22/25)
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  • Case Manager

    Sevita (Benton, AR)
    …and descriptive updates/reports to funding sources and reports case status as part of utilization review on a consistent basis. + Assures that clinical reports ... integrated treatment plan, status updates, funding updates, rate negotiations, and utilization review documentation within expected time parameters. + Maintains… more
    Sevita (09/09/25)
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  • Advanced Clinical Pharmacist

    HCA Healthcare (Denver, CO)
    …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... to promote rational drug therapy and make improvements identified by drug utilization evaluations. + Provide accurate and timely medication information to healthcare… more
    HCA Healthcare (08/31/25)
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  • Clinical Analyst Appeals

    Beth Israel Lahey Health (Charlestown, MA)
    …familiarity with CPT/HCPCs/DRG coding experience required. * Clinical education and/or utilization review experience is strongly preferred. * Requires minimum ... aspects of clinical appeals, audits, and compliance issues to management . * Participates in complex projects related to denial...managers are involved. * Assist in the tracking and review of payer audit and denial results. Prepare appeal… more
    Beth Israel Lahey Health (10/11/25)
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  • Director, Organ Optimization

    LifeCenter Northwest (Bellevue, WA)
    …Organ Procurement, assumes responsibility for donor clinical assessment, donor management , organ allocation, and procurement. Leadership Responsibilities + Provides ... and evaluation of all aspects of donor clinical assessment, donor management , organ allocation, and organ procurement. + Supports LifeCenter Northwest's (LCNW)… more
    LifeCenter Northwest (09/20/25)
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  • RN Care Manager - UNC Disposition Resource Team

    UNC Health Care (Chapel Hill, NC)
    …to ensure smooth transitions of care + Serve as a key resource in case management , utilization review , and discharge planning + Stay compliant with all ... 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely… more
    UNC Health Care (09/06/25)
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  • Utility and Railroad Engineer

    State of Indiana (Vincennes, IN)
    …a District Utility and Railroad Coordinator within the Vincennes District Capital Program Management (CPM) Department. The main role of this position is to determine ... This position is located in INDOT's Vincennes District, Capital Program Management Department. Engineer Trainee: A Professional Engineering license is not required… more
    State of Indiana (09/04/25)
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  • Registered Nurse

    US Tech Solutions (Columbia, SC)
    …change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within ... prioritize effectively and have critical thinking skills. + Experience in case management or care coordination and telephonic care experience is preferred. + A… more
    US Tech Solutions (08/08/25)
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  • Supervisor, Care Delivery Patient Access

    Commonwealth Care Alliance (Boston, MA)
    …is responsible for providing primary care, palliative care and community intensive care management to a specific panel of high risk and complex people. This patients ... we serve are most often are individuals with significant medical, behavioral , and social complexities that require intensive care delivery. Within the Care Delivery… more
    Commonwealth Care Alliance (09/30/25)
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  • Physician (Regular Ft) Psychiatrist

    Veterans Affairs, Veterans Health Administration (Linthicum Heights, MD)
    …psychiatric evaluations, develop treatment plans, implement treatment, and provide clinical management for a variety of complex mental health conditions, including, ... psychosis, and other related conditions. Treatment planning focuses on utilization of pharmacological, psychotherapeutic and technological interventions as well as… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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