• RN Case Manager Women and Children Contingent…

    Tenet Healthcare (Detroit, MI)
    …Complex Case Review . May delegate the implementation of the transition plan to LVN / LPN or Assistant staff. And follows up to ensure the transition plan is ... patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and...Conditions of Participation and Tenet policies. Operates within the LVN / LPN scope of practice as defined by… more
    Tenet Healthcare (08/09/25)
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  • Patient Therapy Access Specialist

    Abbott (Plano, TX)
    …required clinical information for authorizations. + Work with respective carrier's utilization review department to obtain appropriate authorizations. + Assist ... degree ( +/- 13 years) , In Nursing/Home Health ( LVN / LPN ) or related field required ,or, an...Worker's Compensation and Medicare guidelines pertaining toProspective and Retrospective Utilization Review . Some experience in medical deviceor… more
    Abbott (07/18/25)
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  • Medical Management Clinician Senior 100% Virtual

    Elevance Health (CA)
    utilization review experience. + Current active, valid and unrestricted LPN / LVN or RN license and/or certification to practice as a health professional ... not require the training or skill of a registered nurse . Acts as a resource for more junior clinicians....initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses… more
    Elevance Health (06/06/25)
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  • Medical Management Clinician Associate

    Elevance Health (Tampa, FL)
    utilization review experience. + Current active, valid and unrestricted LPN / LVN or RN license and/or certification to practice as a health professional ... of Elevance Health's family of brands. We are a licensed health maintenance organization with health plans for people...not require the training or skill of a registered nurse . **How you will make an impact** Primary duties… more
    Elevance Health (08/08/25)
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  • Clinical Reviewer, Nurse - 9am -6pm PST

    Evolent (Lansing, MI)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical /Vocational Nurse with a current, ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on… more
    Evolent (08/01/25)
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  • Clinical Social Worker Case Management Contingent…

    Tenet Healthcare (Detroit, MI)
    …and/or medication adherence. · May delegate the implementation of the transition plan to LVN / LPN or Assistant staff. And follows up to ensure the transition plan ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
    Tenet Healthcare (07/17/25)
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  • Director of value analysis

    US Tech Solutions (Tarrytown, NY)
    …equivalent combination of education and experience such as MD, RN, PA, CNA or LPN / LVN . Minimum of seven years' experience in Healthcare, project coordination, ... initiatives. - Lead material resource selection, standardization, price optimization and utilization initiatives while promoting and utilizing Value Analysis in the… more
    US Tech Solutions (07/18/25)
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