• Appeals Nurse

    Humana (St. Paul, MN)
    **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals . The Appeals Nurse 2 ... accreditation requirements for member and provider issues. Coordinates the clinical resolution with internal/external clinician support as...+ Active unrestricted RN license + 3 years of clinical RN Experience + Appeals nursing experience… more
    Humana (12/11/25)
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  • Utilization Review Clinician (Santa…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $35.00-44.19 Per Hour ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
    Sacramento Behavioral Healthcare Hospital (12/11/25)
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  • Associate Director for Crisis Services/…

    University of Southern California (Los Angeles, CA)
    …a group of senior faculty clinicians; hold weekly small group meetings; provide clinical consultation; review and approve time off and continuing education ... are strongly committed to providing excellent multiculturally and trauma-informed clinical treatment, training, advocacy, prevention, and outreach services. We are… more
    University of Southern California (11/19/25)
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  • CDOC Social Worker/Counselor III Mental Health…

    State of Colorado (Sterling, CO)
    …Social Worker/Counselor III Mental Health Clinician /Gender Affirming Care - (STERLING) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5054592) ... Apply  CDOC Social Worker/Counselor III Mental Health Clinician /Gender Affirming Care - (STERLING) Salary $6,885.00 -...for inmates experiencing acute mental health crisis. * Renders clinical direction to non- clinical staff in mental… more
    State of Colorado (10/16/25)
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  • Mental Health Clinician I - Colorado Mental…

    State of Colorado (Denver, CO)
    Mental Health Clinician I - Colorado Mental Health Hospital in Fort Logan Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5157498) Apply  ... Mental Health Clinician I - Colorado Mental Health Hospital in Fort...addresses safety violations in patient care areas. Using therapeutic clinical skills, anticipates and initiates intervention at an appropriate… more
    State of Colorado (12/03/25)
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  • Senior Behavioral Health Clinician

    City and County of San Francisco (San Francisco, CA)
    …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
    City and County of San Francisco (10/03/25)
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  • Behavioral Health Clinician - Citywide

    City and County of San Francisco (San Francisco, CA)
    …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
    City and County of San Francisco (10/03/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Orem, UT)
    …(Team will work on set schedule) Looking for a RN with experience with appeals , claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support ... for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical more
    Molina Healthcare (12/01/25)
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  • Pharmacist - Clinical Pharmacist Advisor…

    US Tech Solutions (May, OK)
    …Pharmacist/ Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior authorization as ... per policy and procedure. + The Pharmacist/ Clinician will apply clinical knowledge to plan...urgent PA request as needed. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations… more
    US Tech Solutions (10/30/25)
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  • Clinical Supervisor - Substance Use…

    Whitney Young Health Center (Albany, NY)
    …to continually assess and improve the quality of patient services-conducts monthly utilization review . + Participates in the recruitment of clinical staff. + ... Clinical Supervisor - Substance Use Disorder Programs (Req...patient access to care, enhance program census, and achieve clinician productivity standards. + Leads and engages clinicians in… more
    Whitney Young Health Center (11/22/25)
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