• Workers Compensation | Claims Representative…

    Sedgwick (Concord, CA)
    …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred.… more
    Sedgwick (12/25/25)
    - Related Jobs
  • Clinical Social Worker

    Beth Israel Lahey Health (Burlington, MA)
    …Hospital and Departmental committees. --Participate in Quality Assurance and or Utilization Review committees as assigned. 25190_LHMC_Clinical Social Worker_C200 ... (con't) Page - 2 - Rev 10Oct 2015 --Actively participate in child/adult treatment team meetings. --Willingly participate in special projects as defined by the department administration . 11) Incorporates Lahey Clinic Guiding Principles , Mission Statement and… more
    Beth Israel Lahey Health (12/24/25)
    - Related Jobs
  • Respiratory Registered Nurse

    Quality Center for Rehabilitation and Healing (Lebanon, TN)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... sessions. + Collaborating with and informing facility staff in areas of patient progress. + Educating members of the team in areas of expertise. + Working with a facility to teach documentation practices which assist the respiratory therapy team. +… more
    Quality Center for Rehabilitation and Healing (12/24/25)
    - Related Jobs
  • Registered Nurse II - Pre-op/PACU

    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; ... and + Performs other related duties as required. Typical Qualifications These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list. EDUCATION, TRAINING, and EXPERIENCE Requires six (6)… more
    Ventura County (12/24/25)
    - Related Jobs
  • Clinical Pharmacy Specialist Gaslight Family…

    Corewell Health (Grand Rapids, MI)
    …role model for staff pharmacists. + Coordinates and implements departmental drug utilization review efforts and other process improvement activities as assigned. ... + Ensures that processes and services are continuously monitored for quality, cost effectiveness, and efficiency. Engages in process and quality improvement activities. Makes and implements recommendations to improve operational efficiency and to implement new… more
    Corewell Health (12/23/25)
    - Related Jobs
  • RN Case Manager

    Cleveland Clinic (Euclid, OH)
    …of eligibility (CTM, ACM, CCM or AHA) + Two years of recent experience in utilization review , quality or care management + Knowledge of acute care and ... accreditation requirements + Experience in discharge planning and quality improvement + Bedside experience **Physical Requirements:** + Requires normal or corrected hearing and vision to normal range. + Ability to perform work in a stationary position for… more
    Cleveland Clinic (12/23/25)
    - Related Jobs
  • Claims Representative - Workers Compensation | Las…

    Sedgwick (Las Vegas, NV)
    …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** Education & Licensing Bachelor's degree from an accredited college or university preferred.… more
    Sedgwick (12/23/25)
    - Related Jobs
  • Pharmacy Technician I - Retail

    Fairview Health Services (Bloomington, MN)
    …may include prior authorizations, vacation supplies, dose changes, price check and drug utilization review . + Process new and refill prescriptions in the ... computer system quickly and accurately; including entering refill authorization requests and entering and calculating complex prescriptions such as compounds and injectables. + Demonstrate comprehensive knowledge of the computer system. Utilize the reporting… more
    Fairview Health Services (12/23/25)
    - Related Jobs
  • Director Post Acute Partnerships (External…

    Genesis Healthcare (NM)
    …experience. 5. Experience in business/development preferred. 6. Prior experience in utilization review or discharge planning preferred. 7. Certifications: CCM, ... LPN or CIRS preferred. Benefits *Variable compensation plans *Tuition, Travel, and Wireless Service Discounts *Employee Assistance Program to support mental health *Employee Foundation to financially assist through unforeseen hardships *Diverse, Equitable, and… more
    Genesis Healthcare (12/23/25)
    - Related Jobs
  • Outpatient Clinician - Arrive Together

    Prime Healthcare (Boonton Township, NJ)
    …meetings as required to ensure continuity of care. Completes all required utilization review tasks as assigned. For Outpatient and Residential services/programs ... transportation to client residence and/or transportation of clients may be required. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A master's degree from an accredited college or university in counseling, psychology, social work, or other health-related… more
    Prime Healthcare (12/23/25)
    - Related Jobs