• Assistant Professor, Medicine, General Internal…

    University of Miami (Miami, FL)
    …QI training + Improving patient satisfaction + Improving patient safety + Peer review , performance improvement, utilization review , root cause analysis, and ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of… more
    University of Miami (12/20/25)
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  • Clinic Physician

    Dignity Health (Arnold, CA)
    …services provided; participate in annual review of patient health records and utilization review studies of the Clinic services + Maintain confidentiality of ... records are transferred as required when patients are referred; participate in an annual review for quality completeness + Is present in the Clinic at least once… more
    Dignity Health (12/20/25)
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  • NICU Case Manager Austin Market Float Pool PRN

    HCA Healthcare (Austin, TX)
    …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... to apply for our NICU Case Manager Austin Market Float Pool PRN opening. We review all applications. Qualified candidates will be contacted by a member of our team.… more
    HCA Healthcare (12/19/25)
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  • Principal Psychiatrist (DMHAS)

    State of Connecticut, Department of Administrative Services (Bridgeport, CT)
    …+ Prepares and/or reviews reports, medical records and correspondence; + Performs utilization review and management functions; + Attends court hearings as ... for patients under the jurisdiction of the Psychiatric Security Review Board (PSRB), patients committed by the superior court...training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the… more
    State of Connecticut, Department of Administrative Services (12/15/25)
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  • Pre-Arrival Authorization Specialist I

    UNC Health Care (Goldsboro, NC)
    …matters/scheduled accounts that require attention to Pre-Arrival Team Lead/Manager. 7. Notify Utilization Review & Case Management regarding any admissions that ... need Clinical Review . 8. Review /Sign/Commit to the Patient Access Work Standards approved by Human Resources 9. Review the Patient Access Weekly Huddle… more
    UNC Health Care (12/10/25)
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  • Quality Coordinator RN - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …in all types of weather conditions. PREFERRED: + Experience in quality improvement and utilization review . + At least 2 years of case management or homecare ... completion and compliance under current guidelines. + Identify and review adverse outcomes for root cause. Review ...and review adverse outcomes for root cause. Review charts to ensure appropriate preventative measures and follow-ups… more
    Mohawk Valley Health System (12/10/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …claims adjudication, clinical coding reviews for claims, settlement, claims auditing and/or utilization review required + 7+ years experience with Optum Claims ... and Massachusetts Medicaid regulations. The role will also be responsible for timely review and research, as necessary on all new and revised coding logic, related… more
    Commonwealth Care Alliance (11/25/25)
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  • Nurse III

    US Tech Solutions (Branchburg, NJ)
    …on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care skill ... Tissue/Blood banking * Critical care skill set. The chart review is critical, and the candidate must have knowledge...international and state regulations during the second level quality review of all **tissue donor files** for tissue submitted… more
    US Tech Solutions (10/17/25)
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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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  • Inpatient Clinical Pharmacist-Med/Surg

    Tufts Medicine (Melrose, MA)
    …either through residency training or prior job experience. 3. Experience in drug utilization review and analysis. **Duties and Responsibilities:** The duties and ... necessary for accurate charging. 11. Participates in multidisciplinary team meetings, review discharge medication lists from skilled nursing facilities and inpatient… more
    Tufts Medicine (01/02/26)
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