• Clinical Care Reviewer

    Commonwealth of Pennsylvania (PA)
    Clinical Care Reviewer ( County Care Management Manager) (Local Government) - Fayette County MH/ID Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5117180) Apply  Clinical Care Reviewer ( County Care Management Manager) (Local… more
    Commonwealth of Pennsylvania (10/30/25)
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  • Nurse Clinical Care Coordinator…

    UPMC (Pittsburgh, PA)
    …Position. Monday-Thursday 8:00am-5:00pm This position travels to patients' homes in Allegheny County . The Nurse Clinical Care Coordinator is responsible ... optimal member care . Conducts comprehensive face-to-face assessments that include a clinical assessment and treatment, a review of the medical, functional,… more
    UPMC (10/28/25)
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  • Nurse Reviewer I

    Elevance Health (Richmond, VA)
    …Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of- care savings across an expanding set of clinical domains, including ... **Nurse Reviewer I** A proud member of the Elevance...reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. + Collaborates with healthcare providers,… more
    Elevance Health (11/01/25)
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  • Psychologist Reviewer - North Carolina

    Elevance Health (Norfolk, VA)
    …neuropsychological testing. **Minimum Requirements:** + Requires Ph.D. or Psy.D in clinical /counseling psychology and managed care experience which includes ... **Psychologist Reviewer ** **Hybrid 1:** This role requires associates to...and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria. Outpatient levels of… more
    Elevance Health (10/22/25)
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  • Psychologist Reviewer

    Centene Corporation (Indianapolis, IN)
    …New Jersey** + Be passionate about delivering high-quality, evidence-based behavioral health care + Support multiple markets to ensure ** clinical excellence** ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
    Centene Corporation (10/29/25)
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  • Therapy Services Reviewer

    Elevance Health (PA)
    The **Therapy Services Reviewer ** is responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational ... impact:** . Follows the system guidelines that makes decisions on approval for care for a patient. . Processes system generated decisions for authorization requests,… more
    Elevance Health (10/29/25)
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  • Psychologist Reviewer

    Centene Corporation (Tallahassee, FL)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... of Florida to be considered. **Position Purpose:** Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical more
    Centene Corporation (10/18/25)
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  • Psychologist Reviewer

    Centene Corporation (Tallahassee, FL)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... of Florida to be considered. **Position Purpose:** Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical more
    Centene Corporation (08/08/25)
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  • Medical Director, Ventura County Health…

    Ventura County (Ventura, CA)
    Medical Director, Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113) Apply  Medical Director, Ventura ... County Health Care Plan Salary $219,417.77 -...of Quality Assurance, Utilization Review and Peer Review systems and programs + Direct patient care more
    Ventura County (10/31/25)
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  • Nurse Practitioner- Pediatric Hub Clinics/North…

    The County of Los Angeles (Los Angeles, CA)
    …Do you have experience in clinical leadership that influences and progresses clinical care , policy and collaboration in a multidisciplinary setting? + No ... NURSE PRACTITIONER- PEDIATRIC HUB CLINICS/NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2588395) Apply  NURSE PRACTITIONER- PEDIATRIC… more
    The County of Los Angeles (09/03/25)
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