Clinical Specialist Utilization Management
Community Health Options
Clinical Specialist, Utilization Management Company: Community Health Options Work Type: Remote Employment: Full Time Location: US Seniority: Mid Level Technologies: Microsoft Office, Electronic health records Requirements: Provides clinical decision support and utilization management; RN license in Maine (or Compact), 2+ years in Utilization Management; knowledge of MCG guidelines. Education: Bachelors Role: Individual Contributor Category: Healthcare Services - Allied Health
- Mary Free Bed Rehabilitation Hospital is seeking a detail-oriented Utilization Review/Reimbursement Specialist to coordinate utilization management across preadmission, admission, continued stay, and discharge. You will handle prior authorizations, complex case reviews...Suggested
- What to expect: Provides timely, comprehensive utilization reviews for behavioral health services for Sheppard Pratt patients. Conducts... ...data-driven analysis, optimized workflows, and strengthened clinical documentation to support medical necessity decisions and successful...Suggested
- ...tango is a leader in the home health management industry and is preparing for... ...We are currently looking for a UM Clinical Support Specialist to join our growing team! This is a... ...in supporting the leadership of the Utilization Management team by collecting, analyzing...SuggestedRemote jobWork at officeLocal areaWork from home
$60.2k - $107.4k
Optum is a global organization that delivers care, aided by technology to help millions live healthier lives. The Utilization Management & Clinical Validation RN role involves reviewing medical records, extracting pertinent details, and crafting evidence-based appeal letters...SuggestedRemote jobFull time- Canopy Children’s Solutions in Jackson, MS is seeking a dedicated Utilization Review Coordinator to manage behavioral health services across programs. You will coordinate interdisciplinary treatment, ensure timely prior authorizations, and partner with PROs, Medicaid,...Suggested
$92k - $138k
...Emergency Department, Materials Management and C-suite. Our engagement with clinical and industry leaders allows us to... ...for a Sr Clinical Solutions Specialist. The position would require the... ...recommendations. Conduct clinical and utilization reviews to identify waste,...Minimum wageFull timeContract workWork at officeLocal areaWorldwideShift workWeekend work$195k - $225k
...territory.We are currently looking for a Clinical Oncology Specialist (COS) to join our Oncology sales team... ...a strategic territory plan, and managing all business results and ROI including... ...functional initiatives, effectively utilizing resources to establish processes for...Live inWork at officeLocal areaImmediate startWorldwideNight shift$195k - $225k
...State.We are currently looking for a Clinical Oncology Specialist (COS) to join our Oncology sales team... ...creating a strategic territory plan, and managing all business results and ROI... ...functional initiatives, effectively utilizing resources and establishing processes...Work at officeLocal areaImmediate startWorldwideFlexible hours- ...Services in Lucedale, Mississippi, is seeking a dedicated Utilization Review Specialist to ensure medical necessity, efficiency, and regulatory... ...The role collaborates with providers, insurers, and case managers to streamline approvals and optimize outcomes. The ideal...
- ...The Hughes Center, part of Universal Health Services, seeks a Utilization Review Coordinator to support resident-centered care in a structured... ...–Friday, dayshift, with responsibilities including reviewing clinical data, preparing UR reports, and collaborating with physicians,...Monday to FridayDay shift
- ...establishes proven protocols for the care and management of wounds, skin, and skin breakdown. The Clinical Specialist uses their expertise to support the vision of UMNA... ..., verbal, and presentation skills. Ability to utilize Microsoft Office, SalesForce.com, Power BI....Work at officeNight shift
$108k
...do. It continues with our one-of-a-kind management program designed to build the best... ...Will Involve Deliver product training and clinical education to surgeons, staff, and new users... ...Sales to identify opportunities for utilization growth and account retention Collaborate...$50k
...field nurse vendorCollaborate with program management to implement and improve adherence... ...degree preferredMinimum of 5 years of clinical experience in a healthcare settingExperience... ..., policies, and procedures including Utilization Management Guidelines and review of PA/...Temporary workWork at officeImmediate startHome office- ...Franciscan Healthcare in West Point, NE is seeking a Utilization Review/Concurrent Analyst to perform case reviews, check medical records, and discuss treatment with patients and providers. You will make recommendations on the appropriateness of care based on research...Monday to Friday
$108k
...It continues with our one-of-a-kind management program designed to build the best managers... ...Opportunity That Awaits YouThe Clinical Specialist will play a critical role in delivering... ...Sales to identify opportunities for utilization growth and account retention.At the core...- ...Clinical Retention SpecialistThe Clinical Retention Specialist is a clinically driven retention role focused on strengthening... ...consultative selling, and relationship management to retain customers through... ...and access considerations.Utilize clinical retention selling techniques...Live inWork at officeLocal areaRemote workShift workAfternoon shift
$61.3k - $122.7k
...Abbott Electrophysiology Clinical SpecialistAbbott is a global healthcare... ...and reports status to manager.Acts as a clinical interface... ...of 6 months in Clinical Specialist position.Minimum of 2 years... ...Demonstrate ability to increase utilization of Abbott Advanced Mapping...- ...Cardiac Rhythm Management Clinical SpecialistProvide technical, educational, operational and sales... ...a voice and taking action.Clinical Specialists are required to be within their assigned... ..., field sales or work experience utilizing complex mathematics, mechanical concepts...Work experience placementWork at officeLocal areaWorldwideWeekend workAfternoon shift
- ...Job Summary The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued stay reviews...Work experience placementLocal area
- ...Berkshire Hathaway Homestate Companies, Workers Compensation Division, in Omaha, is seeking a Utilization Review Specialist to join its Medical Management team. You will ensure medical treatment requests are appropriate and reviewed in line with state laws and company...
$61.3k - $122.7k
...performing work, and report status to the manager. Act as a clinical interface between the medical... .... Minimum of 6 months in a Clinical Specialist position. Minimum of 2 years clinical... ...last 6 months). Ability to increase utilization of Abbott Advanced Mapping and Ablation...$83.1k - $120.36k
...Appeals & Grievances Clinical Specialist The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented... ...experience in appeals & grievances, claims processing, utilization review or utilization management/case...Contract workTemporary workWork experience placementLocal areaRemote work$58.24k - $66.56k
...quality days at home. About the job The Clinical Intake Specialist is an integral member of the ECM care management team. In this role, the Clinical Intake... ...the care team for personalized care planning Utilize evidence-based practices, such as Motivational...Full timeLocal areaRemote workMonday to FridayShift workWeekend workAfternoon shift$72k - $90k
...the district in meeting Cardiac Rhythm Management (CRM) sales and customer service... ...having a voice and taking action. Clinical Specialists are required to be within their assigned... ...healthcare, field sales or work experience utilizing complex mathematics, mechanical...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workFlexible hoursAfternoon shift$120k - $150k
...of-its-kind device in cardiac rhythm management. Your work here has a direct line to... ...belong. The Opportunity: As a Field Clinical Specialist, you will provide comprehensive... ...assigned sites, facilitating device utilization, procedural planning, and logistical...Full timeWork at officeNight shift$195k - $225k
...Doral and Key West) POSITION SUMMARY: The Clinical Oncology Specialist (COS) position is a clinical sales role utilizing clinical oncology, pathology, customer... ...appropriate patient identification and treatment management. PRIMARY RESPONSIBILITIES: Learn...Full timeWork at officeLocal areaImmediate startWorldwide- ...VA ACC). The Facility Pain Management, Opioid Safety, and Prescription... ...support Facility Pain POC/Clinical Leads in the coordination of... ...the time. Clinical Pharmacy Specialist. The clinical pharmacy... ...documenting therapeutic plans utilizing the most effective, least toxic...
$110k - $130k
...LOCATION: North New Jersey The Associate Clinical Oncology Specialist (ACOS) is responsible for contributing to account sales, service, and... ...resources that Natera provides to facilitate test order management Utilize and maintain internal reports of key performance...Work at officeImmediate startWorldwideFlexible hours- ...OPENINGSTGi is currently seeking a Clinical Pharmacy Specialist to provide services at our Community... ...) will focus on drug monitoring and management of therapy, with emphasis on diabetes... ...monitor and document therapeutic plans utilizing the most effective, least toxic and...Full timeWork at office
$110k - $130k
...traveling throughout the assigned territory. The Associate Clinical Oncology Specialist (ACOS) is responsible for contributing to account sales... ...that Natera provides to facilitate test order management Utilize and maintain internal reports of key performance indicators...Contract workFor contractorsFor subcontractorWork at officeImmediate startWorldwideFlexible hoursWeekend workAfternoon shift
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