• Registered Nurse, Inpatient

    VNA Health (Santa Barbara, CA)
    …inservice and nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary records and reports in ... a timely manner. + Applies working knowledge of state, federal local and accreditation regulations for the delivery of hospice services. + Completes, maintains and submits accurate and relevant clinical notes regarding patient's condition. Records pain,… more
    VNA Health (12/07/25)
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  • Clinical Case Manager - Behavioral Health (Field…

    CVS Health (Springfield, IL)
    …Qualifications** + Case management and discharge planning experience. + Managed care/ utilization review experience. + Crisis intervention skills. + Strong ... analytical and problem-solving skills. + Effective written and verbal communication skills. + Strong organizational and interpersonal skills. + Ability to work independently while collaborating effectively with interdisciplinary teams. + Proficiency with… more
    CVS Health (12/06/25)
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  • Occupational Therapist

    Intermountain Health (Billings, MT)
    …experience and all aspects of the Intermountain Operating Model. Participates in utilization review audits. + Meetings: Participates in patient care conferences, ... interdisciplinary meetings, staff meetings, and necessary professional and work groups in collaboration/consensus with leader. + Program Development and Marketing: Contributes to program development and marketing strategies to grow the physical therapy program… more
    Intermountain Health (12/06/25)
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  • Mental Health Professional III License

    HCA Healthcare (Asheville, NC)
    …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... Improvement initiatives. **What qualifications you will need:** + Required Education: Master's Degree in Social Work or related field + Required License/Certifications: Currently licensed as one of the following professionals: LCSW, LPC, LMFT, LMHC, LISW,… more
    HCA Healthcare (12/05/25)
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  • Workers Compensation Claims Adjuster | Dedicated…

    Sedgwick (Rancho Cordova, 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 (12/05/25)
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  • Assessment & Referral Registered Nurse (Weekends)…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. + Maintains knowledge of developmental tasks and ... sociological theories of pertinent age groups. + Maintains knowledge of legal guidelines pertaining to Emergency Medical Treatment & Labor Act (EMTALA)/Consolidated Omnibus Budget Reconciliation Act (COBRA) and abuse/neglect reporting. + Communicates with… more
    Sacramento Behavioral Healthcare Hospital (12/04/25)
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  • RN - Case Manager

    Amergis (Hyannis, MA)
    …management experience in the last 5 years + Experience in discharge planning & utilization review + Knowledge of InterQual or similar system Schedule: 40 hours, ... 8am-4:30pm and every other weekend Duration: 13 weeks Amergis proudly offers weekly pay, BCBS health benefits, Paid Time Off Programs, College Partnership benefits, Perkspot Employee Discount Program, 401K Savings Plan, and Employee Assistance and Work/Life… more
    Amergis (12/03/25)
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  • Medical Director - Commercial

    CVS Health (Austin, TX)
    …and the dedicated Account Team & Employer. In addition, you will oversee utilization review /quality assurance, and provide clinical guidance to support case ... management activity. In this role you'll provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities. You will also act as a lead business and clinical liaison to account teams… more
    CVS Health (12/03/25)
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  • Regional Vice President of Revenue Cycle

    Prime Healthcare (Chicago, IL)
    …financial counseling, patient financial services, and coordination with HIM, Coding, Utilization Review , Charge Master, and Clinical Documentation. Partners ... closely with the offshore team in managing end-to-end revenue cycle efficiency and results. The Regional VP identifies trends and assists in the management of payor trends, productivity, AR management, DNFB, payor and patient cashflow and, denials, including… more
    Prime Healthcare (12/03/25)
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  • RN MDS Coordinator

    Erickson Living (Springfield, VA)
    …of MDS processes, including but not limited to MDS, RAPs, Care Planning, and Utilization Review . + Experience documenting in an Electronic Medical Record (EMR) ... preferred. + Successful completion of AANAC MDS Coordinator Certification. Please note that specific state regulations and requirements may be applicable. These regulations take precedence over the requirements outlined in the job description. Greenspring is a… more
    Erickson Living (12/03/25)
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