• Senior Clinical Nurse Specialist Medical

    Immigration and Customs Enforcement (Washington, DC)
    …national process changes identified by unit chart reviews, nursing incident reports, Medical Quality Management Unit (MQMU) review /reports, and any corrective ... utilization and documentation of translation services within the medical record, to include providing corrective actions necessary to ensure appropriate… more
    Immigration and Customs Enforcement (11/06/25)
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  • VP, Medical Affairs And Chief…

    UNC Health Care (Goldsboro, NC)
    …with reputation as an excellent clinician. Physician leadership experience as a Medical Director , Clinical Chair or other significant medical -administrative ... system initiatives into Wayne UNC Health Care. 3. Assists Medical Staff in the review of the...the following hospital departments: Medical Staff Services, Medical Staff Performance Improvement, Utilization Management, Clinical… more
    UNC Health Care (08/25/25)
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  • RN Acute Case Manager - Medical Social…

    Guthrie (Troy, PA)
    …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... health and community providers. a) Works closely with the Medical Director and other members of the...other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved… more
    Guthrie (11/06/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …under the direction of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years Experience in ... in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning… more
    Sharp HealthCare (10/07/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5.… more
    Corewell Health (11/04/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. +… more
    Corewell Health (10/17/25)
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  • Physician Advisor

    HonorHealth (AZ)
    …stay, and use of resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations. As a CDI ... in the message to all constituents. Essential Functions + Medical Record Review : Conducts medical ...and optimal reimbursement. + Attends JOC as requested by Utilization Management or Managed Care: Works with Director more
    HonorHealth (09/17/25)
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  • Medical Management Nurse

    Elevance Health (Columbus, GA)
    …nursing judgment to determine whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not satisfy ... not in line with diagnosis. + Provide consultation to Medical Director on particularly peculiar or complex...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
    Elevance Health (10/28/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    …site) **Job Location** : Maitland, FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation of ... methodology, data tools, modeling, managing revenue, and managing and mentoring of director reports. Must be able to complete extensive and complex financial,… more
    AdventHealth (08/19/25)
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  • Associate Chair of Oncology - Physician - Valley…

    Mount Sinai Health System (NJ)
    … Oncology leader to serve as Associate Chair, Oncology Services, VMG, and Director , Hematology and Medical Oncology. Valley-Mount Sinai Comprehensive Cancer Care ... Line Executive Committee of the Valley Hospital (TVH). As Director , Hematology and Medical Oncology, the role...goals and objectives + Perform a formal Annual Performance Review for each VMG hematologist and/or medical more
    Mount Sinai Health System (10/21/25)
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