• RN Case Manager - Case Management - Full-Time…

    Cedars-Sinai (Marina Del Rey, CA)
    …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... identified contracted/private patients collaborates with on-site and/or outside reviewers. + Keeps patients informed of progress and provides information related to disease progression. + Collaborates with discharge planner to make orders and arranges for home… more
    Cedars-Sinai (12/17/25)
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  • Clinical Pharmacist - Patient Care

    Adecco US, Inc. (Minneapolis, MN)
    …recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review program protocols providing clinical recommendations ... and the 5 Core Elements of MTM Services (1) Medication Therapy Review - Comprehensive and Targeted, 2) Personal Medication List (PML), 3) Medication-Related… more
    Adecco US, Inc. (12/17/25)
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  • Director of Quality Improvement/ Risk Management/…

    San Antonio Behavioral Health (San Antonio, TX)
    …knowledge and skills in areas of risk management, infection control, and utilization review ; strong oral and written communication skills, current knowledge ... Also, responsible for developing, implementing and monitoring of a quality review program. Essential Duties: + Directs the collection, measurement and presentation… more
    San Antonio Behavioral Health (12/16/25)
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  • Clinical Staff Pharmacist Mail Order

    Beth Israel Lahey Health (Westwood, MA)
    …to enter and access patient care information. 7. Participates in quality management and utilization review programs. 8. May coordinate the work of a small group ... to accomplish a project or assignments, review of policies and procedures or standard operating procedures. 9. May assist in the development, implementation, and… more
    Beth Israel Lahey Health (12/16/25)
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  • RN Case Mgr PRN

    HCA Healthcare (Wichita, KS)
    …of critical care experience is preferred + Certification in case management or utilization review is preferred + InterQual experience is preferred **For more ... encourage you to apply for our RN Case Mgr PRN opening. We review all applications. Qualified candidates will be contacted for interviews. **Unlock the possibilities… more
    HCA Healthcare (12/13/25)
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  • Insurance Case Manager - Northern

    Insight Global (Alexandria, LA)
    …Skills and Requirements Current RN License Cost Containment Background - utilization review or managed care Prior Experience with Worker's ... Compensation Prior Experience with Case Management more
    Insight Global (12/13/25)
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  • RN Clinical Documentation Specialist

    Trinity Health (Maywood, IL)
    …through a thorough understanding of Milliman and InterQual criteria, conducts concurrent utilization review . Interacts with insurers, third party payors, and ... review entities such as EQ Health for Medicaid to relay clinical information and to certify inpatient care for payment. Records all interactions in department databases and software such as Allscripts. **Perks & Benefits** + Benefits from Day One (Medical… more
    Trinity Health (12/11/25)
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  • Pharmacist Intern PRN

    HCA Healthcare (Plantation, FL)
    …the Intern may also participate in 1) the provision of pharmaceutical care, 2) drug utilization review ; 3) ensuring the proper and safe storage of drugs and ... encourage you to apply for our Pharmacist Intern PRN opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member… more
    HCA Healthcare (12/11/25)
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  • Organizational Quality Nurse Specialist

    Hospice of Michigan (Ann Arbor, MI)
    …work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical ... personnel on the QAPI plan, and team development. + Performs clinical record review activities for data collection. + Compiles, analyzes, trends and reports quality… more
    Hospice of Michigan (12/10/25)
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  • Branch Director - Hospice

    Elara Caring (San Antonio, TX)
    …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... of Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all public information, materials, and… more
    Elara Caring (12/10/25)
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