Multi-Specialty Medical group is seeking a strong candidate, responsible for ensuring the continuity of care in both the inpatient and outpatient setting. Responsible for utilizing the appropriate resources within the parameters of contracts and patients health plan
Utilization Review Specialist | Remote | Full-Time $50,000 – $65,000 Annually | Weekdays (Weekend Availability as Needed) Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this
Mahalo for your interest in this role! Please see the full position description below and click Start Your Application when ready. For more information about DAWSON, please visit https://www.laukoa.com. Registered Nurse Case Manager We are seeking
Mahalo for your interest in this role! Please see the full position description below and click Start Your Application when ready. For more information about DAWSON, please visit https://www.laukoa.com. Registered Nurse Case Manager We are seeking
SUMMARY The Department of Orthopedics at Rochester Regional Health is seeking an additional Nurse Practitioner to join our growing Sports Medicine team. Our advanced practice providers are an integral part of our collaborative orthopedic practice, working
Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without
Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track
Clinical Quality Assurance Specialist (Remote) Contract‑to‑Hire | RN: $28.50/hr | LPN: $26.50/hr (Non‑Negotiable) Location: 100% Remote About the Role Network Medical Review Company is seeking an entry‑level Clinical Quality Assurance Specialist to support the Quality Assurance Department in
Anticipated End Date:2026-10-31 Position Title:LTSS Service Coordinator – Clinician (LSW, LCSW, LPN) Western Ohio Job Description: LTSS Service Coordinator – Clinician Candidates should be located in one of the following counties: Butler, Warren, Clinton, Clermont, Hamilton,
Responsible for project activities associated with monitoring functions of phase I through phase IV clinical research studies and Real World Evidence (RWE) studies, while continuing to develop knowledge of drug development process, International Council for Harmonisation
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive
Anticipated End Date:2026-08-21 Position Title:Behavioral Health Care Manager I Job Description: Behavioral Health Care Manager I Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy.
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of care
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of care
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,