Clinical Evaluation & Utilization Manager
VNS Health
VNS Health seeks a qualified nurse to assess member needs, authorize services, and coordinate care management within regulatory guidelines. You will work with medical teams to ensure appropriate, timely, cost-effective care and discharge planning. Requirements include an NY RN license, preferred CM certification, and 2 years in cost containment or acute inpatient settings. Strong organizational and communication skills are essential for success. #J-18808-Ljbffr VNS Health
$153.72k - $230.58k
DescriptionThe Director of Clinical Pharmacy Services provides strategic... ...responsible for formulary management, clinical practice... ...medication stewardship and utilization management strategies, and ensure... ...requires dedicated expertise to evaluate clinical value, monitor...SuggestedFull timeTraineeshipLocal area- ...Clinical Account Manager Manhattan, NY | Surgical Robotics & Minimally Invasive Surgery Position... ...expertise while also helping drive utilization and long‑term account growth. Candidates... ...opportunities. Support product evaluations, in‑services, and value analysis committee...Suggested
$85k - $106.3k
...effective health care services. Manages providers, members, team, or... ...services and renders clinical determinations in accordance... ..., and discharge planners in utilization tracking, care coordination,... ...analysis of initial health evaluation and comprehensive assessment...SuggestedWork experience placementFlexible hours$125k - $191k
...subject to Fair Market Value evaluation. The hiring range listed is a... ...Process Improvement Actively manage the day-to-day throughput of... ...Management & Staff Engagement Utilize all aspects of the performance... ...and verification of clinical competencies Ensure optimized...SuggestedFull timeWork at officeLocal areaRemote workMonday to FridayShift work$65k - $90k
...serve, Commonpoint is hiring a Clinical Director, Adolescent... ...consultation, case conferences, utilization review, and other quality-improvement... ...complete required intern evaluations within established deadlines... ...in the agency's performance management process by establishing...SuggestedTraineeshipInternshipSeasonal workLocal area- ...We are seeking an experienced full-time Clinical Director of Residential Services to... ...20 residential model Participate in evaluation of assigned staff and interns Co-lead... ...Improvement Committee Monitor and support Utilization Review and authorizations for treatment...Full timeLocal area
- ...ServicesOur health plans work closely with both plan members and their health care providers to keep our members’ health on track. From managing populations requiring long term services and supports, to complex cases and end-of-life and palliative care, you will play a...Live in
$95k - $105k
...Range: $95,000 - $105,000 Reports to: Clinic Operations Manager Employment Type: Exempt/Salaried... ...clinical staff Conduct annual performance evaluations, set growth goals, and address... ...care Participate in case reviews, utilization management, IRC meetings, and quality...Full timeTemporary workWork at officeFlexible hoursAfternoon shift$140k - $175k
...About the Role The Director of Clinical Quality serves as Equip's primary owner of clinical quality and patient safety, responsible... ...and accountability while providing direct oversight of the Utilization Management (UM) program. The Director of Clinical Quality reports...Work at officeLocal areaRemote workWork from homeHome officeFlexible hours- ...A leading virtual health company is seeking a Director of Clinical Quality to oversee its clinical quality functions in the virtual... ...health, including expertise in quality improvement and utilization management. This is a remote position with a focus on maintaining high...Remote work
$257.94k - $368.49k
...Associate Market Clinical Director The Associate Market Clinical Director directly supervises, performance manages, and trains Clinical Directors within an assigned market, overseeing... ...for market referral and delegated utilization authorizations. Other duties as assigned...Full timeWork at officeLocal area$85k - $106.3k
...and equitable member care. Serves as a clinical and operational resource to QI... ...experience. Designs, implements, and evaluates QI programs aligned with DOH, CMS, and... ...Collaborates across departments—including Care Management, Utilization Management, Provider Relations,...Work experience placementFlexible hours$223.2k - $262.7k
...an impact?West Monroe is hiring a Senior Manager with experience in electric and/or gas... ...platforms and solutions to join our Energy and Utilities Practice. Our team is at the forefront... ...for clients, exercising judgment in evaluating outputs.Apply AI technologies (e.g., generative...Local areaImmediate startFlexible hours$90k - $110k
Project Manager - Clinical Trial Operations Exp. Req. (Job 1421) United States - Remote About Us DLH delivers improved health and national... ...digital transformation. Our experts in public health, performance evaluation, and health operations solve the complex problems faced by...Contract workTemporary workRemote workFlexible hours- ...York City jails since 2016. The in‑jail clinical services include medical, nursing, and mental... ...the city‑wide Forensic Psychiatric Evaluation Court Clinics (FPECC), providing objective... ...Clinic Administrator, the Coordinating Manager oversees the daily operations of the...Full time
$79.68k
...research under one roof. CJA utilizes procedural justice practices... ...used to conduct descriptive and evaluation research on arrestee... ...Summary Reporting to the ICM Clinical Supervisor, and under the direction... ...II for ICM, the Clinical Case Manager I is a dynamic, knowledgeable...Work at officeWork from homeFlexible hoursNight shiftAfternoon shift$159k - $190.57k
...Description MSHS seeks an Ambulatory Care Clinical Pharmacy Manager that reports to the Senior Director,... ...with design, implementation and evaluation of all related pharmacy initiatives.... ...• Support financial, quality and utilization analytics and performance...Full timeTraineeshipLocal area- Overview Area Clinical Manager role is responsible for planning and coordinating a comprehensive... ...clinical outcomes and community utilization Assist in recruitment, interviewing and... ...facility Deliver Rehabilitation Services: Evaluation and Treatment as indicated based upon...
- .... Position Details: As the Site Manager for the Healthy Brain Network (HBN), you... ...upkeep of all equipment, and liaise with clinical and research leadership to implement... ...clinical direction into daily site operations, evaluate business procedures, and implement...Full timeWork experience placementWork at officeLocal areaFlexible hours
$68 - $72 per hour
...Field Nurse Supervisor (RN) – Home Care Clinical Oversight Multiple Territories Across... ...nursing supervisory visits and competency evaluations Strong knowledge of home care... ...experience OASIS knowledge Case management or care coordination experience Bilingual...Hourly payPermanent employmentFull timeTemporary workImmediate startMonday to FridayWeekend workWeekday work$22 - $25 per hour
..., Essen has five integrated clinical divisions offering urgent care... ...home staffing and care management. Founded in 1999, our over 2... ...Conduct in-person assessments to evaluate medical and social needs.... ...and increase preventive care utilization. Schedule medical appointments...Work at office- ...associates, please click here. Overview The Clinical Pharmacy Manager for Infectious Diseases and... ...settings. Monitor and improve antimicrobial utilization metrics, resistance patterns, and patient safety outcomes. Evaluate new and existing ID-related technologies...Traineeship
$1,800 per month
...diverse atmosphere. The Regional Clinical Development Manager (RCM) is responsible for a broad range... ...labs looking at design changes and evaluating future product enhancements.... ...exposures. PPE must be obtained and utilized when performing all patient exposure...Remote jobWork at officeHome officeShift workNight shift- The Clinical Pharmacy Manager provides strategic and operational leadership for clinical pharmacy services... ...Management Supervise, mentor, and evaluate clinical pharmacy staff. Develop... ...Manage departmental budgets and resource utilization. Identify opportunities to improve...
$159k - $190.57k
...Responsible for carrying out clinical pharmacy services, promoting... ..., medication use evaluations and institutional committee... ...review, and evaluate the cost, utilization, safety and effectiveness of... ...centered medication therapy management, including medication reconciliation...Full timeTraineeshipLocal area- ...s lives. Work Shift Job Summary The Clinical Pharmacy Manager shall identify, develop, implement and... ...clinical staff on appropriate utilization of medications. Assume responsibility... ...budgetary process). Perform annual evaluations/appraisals for clinical pharmacists,...Local areaShift work
- Luminare Health is seeking a Senior Manager, Clinical Review to lead the daily operations of the Clinical Review Department within Healthcare Management, overseeing Utilization Management and Claims Medical Management, and supporting the Utilization Review Program. Remote...Remote job
$155k - $175k
Senior Clinical Quality & Patient Relations Manager Reports to: Director of Quality & Safety About the Role: Midi is seeking a Senior Clinical Quality &... ...read a chart, understand a prescribing decision, and evaluate whether a risk‑benefit discussion was meaningfully documented...H1bImmediate start$77.55k - $189.35k
...focuses on accounts within the Automotive, Utilities and Energy Industries. Some positions... ...on the team.Responsibilities:Build and manage a sales pipeline by prospecting new accounts... ...Energy industries.Experience will be evaluated based on core competencies, including extracurricular...Full timeWork at officeRemote workFlexible hours$96.3k - $131.3k
...within agreed timelines and budget. Manages the regional clinical operations team (incl oversight of external... ...of any issues arising on the study, evaluates impact and ensures solutions are... .... Monitors regional resource utilization over study life cyle and liaises with...Hourly payLocal areaWorldwide
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