- Common Ground (Bingham Farms, MI)
- …a unique combination of customer service, crisis intervention, resource guidance, utilization review , mobile crisis oversite and dispatch, Behavioral Health ... to Common Ground. To learn more about this position, please review the job description: Common Ground Crisis Hub - Manager… more
- CareFirst (Baltimore, MD)
- …related experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... and/or social determinant of health needs. Engage members and providers to review and clarify treatment plans ensuring alignment with medical benefits and policies… more
- PruittHealth (Albany, GA)
- …years industry experience in a managed care setting focused on experience in utilization review /case management and at least two years case management, home ... for each patient based on a thorough history and clinical record review , including the attending physician's plan, the recommendations of national guidelines, social… more
- HCA Healthcare (Dublin, GA)
- …Case Management is highly preferred.** + **Certification in Case Management or Utilization Review is preferred.** + **InterQual experience is preferred.** ... career path, we encourage you to apply for our RN Case Manager opening. We review all applications. Qualified candidates will be contacted by a member of our team.… more
- Health Care Service Corporation (Albuquerque, NM)
- …and decision-making skills. *PC and database experience. **PREFERRED JOB REQUIREMENTS:** * Utilization review experience. *MUST be licensed to practice at the ... Summary** This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members… more
- Actalent (Bridgewater, NJ)
- …+ Collaborate with healthcare providers to clarify prescriptions. + Utilize Drug Utilization Review (DUR) for patient prescription management. + Maintain a ... + Assist with daily workflow related to prescription order processing. + Review prescription orders for appropriateness and accuracy. + Verify orders processed by… more
- Northern Light Health (Bangor, ME)
- …dates, and times of conversations with businesses, insurances, managed care organizations, Utilization Review , and patients are documented, if appropriate + ... understanding of benefit coverage and precertification/authorization, if appropriate + Quality review procedures are followed to ensure accounts are brought to a… more
- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... receive a sufficient number of qualified applications to meet business needs. FIRST REVIEW OF APPLICATIONS: July 15, 2025 Examples Of Duties Duties include but are… more
- University of Miami (Miami, FL)
- …Care Technician to work Per-diem . The Critical Care Technician conducts drug utilization review studies, and consults with medical practitioners on prescription ... 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 University of… more
- Amazon (Richmond, VA)
- …on operational needs and customer centric volume * Perform thorough DUR (Drug Utilization Review ) and ensure accurate documentation in pharmacy systems * ... premium policy. \#everydaybetter Key job responsibilities Perform clinical data review , prescription verification, and virtual patient consultations in compliance… more