Clinical Utilization Review Specialist

Job SummaryWe are seeking a highly skilled Clinical Review Nurse to join our Medical Management team at Centene Corporation. As a Clinical Review Nurse, you will play a critical role in analyzing prior authorization requests to determine medical necessity and appropriateness of care.Key ResponsibilitiesMedical Necessity Reviews: Perform thorough reviews of...

Job Title: Pharmacist - Clinical Engagement SpecialistAdecco Healthcare and Life Sciences is seeking a highly skilled Pharmacist to join our team as a Clinical Engagement Specialist. This is a remote opportunity that requires flexibility to work rotating shifts between 8:00am and 8:00pm CST, Monday through Friday.Responsibilities:Engage members...

Job SummaryCVS Health is seeking a highly skilled Clinical Utilization Management Nurse Consultant to join our team. As a key member of our utilization management team, you will play a critical role in ensuring that our members receive the most appropriate care at the right time and in the right setting.Key ResponsibilitiesUtilize clinical expertise to...

Position Overview:This role necessitates the candidate's relocation to a key operational hub.About Asterix Communications:Asterix Communications is a leader in the exploration, production, transportation, and marketing of energy resources.Company Segments:Upstream: Focuses on the exploration and production of crude oil and natural gas.Downstream:Engages in...

Job SummaryWe are seeking a highly skilled Utility Construction Specialist to join our team at Apex Companies, LLC. As a key member of our operational services team, you will be responsible for repairing and constructing vital stormwater infrastructure, underground utilities, and concrete structures across the central states.Key ResponsibilitiesOperate...

Exciting Opportunity for Clinical Support Specialist RoleWe are actively looking for a Clinical Support Specialist to join a prominent medical device organization. This position entails offering assistance and training to clients during surgical operations utilizing advanced operating room technology. The ideal applicant will possess a healthcare background,...

Accent Title seeks a skilled Title Specialist to join our team. The ideal candidate will have a strong understanding of real estate title insurance commitments and policies. Key responsibilities include abstract review, title issue communication, and comprehensive knowledge of title insurance. The successful candidate will possess experience in real estate...

Job SummaryWe are seeking a skilled Utilization Management Review Nurse to join our team at Humana. As a key member of our healthcare team, you will play a critical role in ensuring that our members receive the best possible care and services.Key ResponsibilitiesUtilize clinical nursing skills to support the coordination, documentation, and communication of...

Position Overview Role Summary: As a vital member of our healthcare team, the Clinical Laboratory Specialist conducts essential laboratory analyses on patient samples, ensuring accuracy and reliability in test results. This position requires a thorough understanding of laboratory techniques, principles, and instrumentation.Key Responsibilities: Execute...

Job SummaryBaton Rouge General is seeking a highly skilled Clinical Laboratory Specialist to join our team. As a key member of our laboratory team, you will be responsible for performing routine and special clinical laboratory tests on patient specimens, correlating and interpreting data, and ensuring the accuracy and reliability of test results.Key...

Position OverviewThe Pediatric Clinical Nutrition Specialist plays a crucial role in assessing and addressing the nutritional needs of patients at risk. This position involves conducting comprehensive nutrition evaluations and devising tailored nutrition care strategies that align with the medical conditions of the patients. The specialist will ensure that...

Position OverviewThe Pediatric Clinical Nutrition Specialist is tasked with recognizing patients at nutritional risk, performing comprehensive nutrition evaluations, and developing tailored nutrition care strategies that align with the specific needs of each patient. This role focuses on delivering nutrition care based on medical diagnoses while adhering to...

Position OverviewThe Pediatric Clinical Nutrition Specialist is tasked with recognizing patients at nutritional risk, performing comprehensive nutrition evaluations, and executing tailored nutrition care strategies based on individual patient requirements. This role involves planning and delivering nutrition interventions aligned with medical diagnoses while...

Position OverviewThe Pediatric Clinical Nutrition Specialist is tasked with recognizing patients at nutritional risk, performing comprehensive nutrition evaluations, and formulating a tailored nutrition care strategy that aligns with the individual needs of each patient. This role involves planning and executing nutrition interventions based on medical...

Position OverviewThe Appeals Management Specialist plays a crucial role in the handling of appeal notices and updates. This position is responsible for:File Management: Creating and maintaining organized files for all new appeals received.Review Process: Analyzing new appeals to assess the adverse action taken, the reasons for the appeal, and ensuring timely...

Job SummaryBaton Rouge General is seeking a highly skilled Clinical Laboratory Specialist to join our team. As a key member of our laboratory team, you will be responsible for performing routine and special clinical laboratory tests on patient specimens, correlating and interpreting data, and ensuring the accuracy and reliability of test results.Key...

About the RoleWe are seeking a highly skilled Territory Manager to join our Structural Heart TAVI division at Abbott Laboratories. As a key member of our team, you will be responsible for ensuring that assigned territories meet or exceed sales and clinical objectives.Key ResponsibilitiesCollaborate with the Regional Sales Director to identify account...

Job SummaryWe are seeking a skilled Utilization Management Coordinator to join our team at Humana. As a key member of our Wisconsin Medicaid Market team, you will play a critical role in ensuring the best and most appropriate treatment, care, or services for our members.Key ResponsibilitiesProcess and document all incoming inpatient and outpatient prior...

About Ochsner HealthWe are a leading healthcare organization committed to serving, healing, leading, educating, and innovating. Our team is dedicated to making a difference in the lives of our patients and communities.Job SummaryWe are seeking a skilled Pediatric Nurse Triage Specialist to join our team. As a key member of our pediatric clinic, you will be...

Job SummaryOchsner Health is seeking a highly skilled Clinical Pharmacist to join our team. As a Clinical Pharmacist, you will play a critical role in ensuring the delivery of high-quality patient care and improving patient outcomes.Key ResponsibilitiesManage and oversee pharmacy services to ensure complete and appropriate drug therapy for...