• RN Care Coordinator Wellness - Strategic…

    Guthrie (Sayre, PA)
    …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... experience preferred. Education Licensed Registered Nurse with 5 years' experience, preferably in an outpatient/ambulatory setting. Bachelor's Degree in Nursing… more
    Guthrie (07/15/25)
    - Related Jobs
  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    Care Manager - Readmission Specialist **_Position Summary_** _At Stony Brook Medicine the_ Care Manager - Readmission Specialist _must have both hospital and ... may be at a high risk for readmission. The RN following these patients must have good clinical and...of excellence._ Duties of a Care Manager - Readmission Specialist may include the following but are not limited… more
    Stony Brook University (07/15/25)
    - Related Jobs
  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... any other healthcare provider. We are seeking a(an) Assessment Specialist PRN to join our healthcare family. **Benefits** TriStar...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
    HCA Healthcare (06/21/25)
    - Related Jobs
  • Clinical Pharmacist Specialist BMT

    HCA Healthcare (Dallas, TX)
    …this opportunity compelling, we encourage you to apply for our Clinical Pharmacist Specialist BMT opening. We promptly review all applications. Highly qualified ... **Description** **Clinical Pharmacist Specialist BMT** **Full Time Day Shift Position, rotating...in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement… more
    HCA Healthcare (07/14/25)
    - Related Jobs
  • Per Diem Diagnosis/Oasis Specialist

    St. Luke's University Health Network (Bethlehem, PA)
    …conditions, snow, ice and/or fog. Hazards - road and driving. EDUCATION: PA-Licensed Registered Nurse or Physical Therapist. A bachelor's degree in specific ... patient's ability to pay for health care. The Diagnosis and OASIS Specialist is responsible for coding pertinent medical information on patient classifications… more
    St. Luke's University Health Network (07/22/25)
    - Related Jobs
  • Clinical Inpatient Rehab Specialist

    HCA Healthcare (Kissimmee, FL)
    …personal growth, we encourage you to apply for our Clinical Inpatient Rehab Specialist opening. We promptly review all applications. Highly qualified candidates ... care like family! Jump-start your career as a(an) Clinical Inpatient Rehab Specialist today with HCA Florida Osceola Hospital. **Benefits** HCA Florida Osceola… more
    HCA Healthcare (08/08/25)
    - Related Jobs
  • RN -Education Spec-Clin Center for Learning…

    Albany Medical Center (Albany, NY)
    …field of Clinical Social Work or Nursing with experience in Case Management, Utilization Review and Discharge Planning. * BLS Certification. * Demonstrated ... will be prorated based on hours worked. The Education Specialist is expected to utilize their knowledge and skills...to accomplish the goals of the organization. The Education Specialist achieves this goal through the roles of educator,… more
    Albany Medical Center (06/03/25)
    - Related Jobs
  • Certified Strength Conditioning Specialist

    HCA Healthcare (Richmond, VA)
    …compelling, we encourage you to apply for our Certified Strength Conditioning Specialist opening. We promptly review all applications. Highly qualified ... individual is recognized. Submit your application for our Certified Strength Conditioning Specialist opening with Chippenham Hospital today and find out what it… more
    HCA Healthcare (06/21/25)
    - Related Jobs
  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …claims adjudication, clinical coding reviews for claims, settlement, claims auditing and/or utilization review required + 7+ years experience with Optum Claims ... regulations. The role will also be responsible for timely review and research, as necessary on all new and...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
    Commonwealth Care Alliance (05/28/25)
    - Related Jobs
  • Case Management Specialist

    Parkview North Hospital (Fort Wayne, IN)
    …installing systems to obtain precertification and recertification for payment and utilization review . Attends treatment planning to advise regarding ... (ASN); Bachelor of Science in Nursing (BSN) preferred. Licensure/Certification Current Indiana RN license. CPI required upon hire or within 3 months of employment.… more
    Parkview North Hospital (08/08/25)
    - Related Jobs