Clinical Utilization Review Specialist

Job Title: Utilization Review SpecialistThe Utilization Review Specialist at Premier Health Group plays a critical role in ensuring that services provided to clients are authorized by insurance companies, thereby securing payment for services. This position involves obtaining and tracking authorizations, ensuring timely communication with payers, and...

Job SummaryWe are seeking a skilled Clinical Review Specialist to join our team at Saviance Technologies. As a key member of our Utilization Management team, you will play a critical role in ensuring that our members receive the right care at the right time.Key ResponsibilitiesConduct daily reviews and evaluations of members requiring hospitalization and/or...

About the RoleThe Facility Compliance Review team at Blue Shield of California reviews post-service prepayment facility claims for contract compliance, industry billing standards, medical necessity, and hospital-acquired conditions/never events. As a Utilization Management Nurse, Senior, you will report to the Senior Manager, Facility Compliance Review. In...

Job SummarySaviance Technologies is seeking a skilled Clinical Review Clinician I 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 right care at the right time.Key ResponsibilitiesConduct daily review and evaluation of members requiring hospitalization and/or...

Job SummarySaviance Technologies is seeking a highly skilled Care Review Clinician I to join our Utilization Management team. As a key member of our team, you will be responsible for conducting inpatient medical necessity and utilization reviews, ensuring our members receive appropriate care when they need it.Key Responsibilities:Conduct thorough reviews and...

Job SummaryHoag Memorial Hospital Presbyterian is seeking a highly skilled and compassionate Clinical Nurse to join our team in an outpatient setting. As a key member of our healthcare team, you will provide exceptional patient care, work collaboratively with other healthcare professionals, and contribute to the delivery of high-quality patient services.Key...

Clinical Documentation Specialist Lead **Job Summary:** VirtualVocations is seeking a skilled Clinical Documentation Specialist Lead to oversee daily review assignments for CDI Specialists and facilitate accurate clinical documentation to support coding. **Key Responsibilities:** * Collaborate with healthcare team members to ensure accurate medical...

Job SummaryWe are seeking a highly skilled Clinical Cyber Security Specialist to join our team at Renovo Solutions. As a key member of our Biomedical Engineering department, you will be responsible for ensuring the security and integrity of our medical devices and systems.Key ResponsibilitiesProvide technical support and oversight for clinical information...

Job SummaryAkua Behavioral Health is seeking a dedicated and compassionate Clinical Technician to join our team. As a Clinical Technician, you will play a vital role in supporting our clients in their recovery journey.Key ResponsibilitiesProvide exceptional support to clients and program staff during their shiftConduct thorough orientations to new clients,...

Job Summary:Saviance Technologies is seeking a highly skilled Care Review Clinician I to join our Utilization Management team. As a key member of our team, you will be responsible for conducting inpatient medical necessity and utilization reviews, ensuring our members receive appropriate care when they need it.Key Responsibilities:Conduct thorough reviews...

Job Title: Payroll Specialist Job Summary: We are seeking a highly skilled Payroll Specialist to join our finance team at Jobot. As a Payroll Specialist, you will be responsible for managing and overseeing all aspects of payroll processing, ensuring accuracy and timeliness. You will maintain up-to-date knowledge of wage and hour laws, tax laws, and other...

Job Title: Clinical EvaluatorAcentra Health is seeking a skilled Clinical Evaluator to join our team. As a Clinical Evaluator, you will conduct face-to-face assessments to facilitate appropriate placement and next level of care within Orange County, California.Job Summary:The Clinical Evaluator will evaluate, determine, and recommend the next level of care...

Job SummaryMolina Healthcare Services (HCS) is seeking a skilled Clinical Prior Authorization Specialist - LVN to join our team. As a key member of our healthcare services team, you will work closely with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum.Key...

Job SummaryAcentra Health is seeking a skilled Clinical Evaluator to join our team. As a Clinical Evaluator, you will conduct face-to-face assessments to facilitate appropriate placement and next level of care within Orange County, California.Key ResponsibilitiesConduct thorough assessments to evaluate patients' psychological, emotional, behavioral, and...

Job SummaryWe are seeking a highly skilled and experienced Payroll Specialist to join our finance team at Jobot. As a Payroll Specialist, you will be responsible for managing and overseeing all aspects of payroll processing, ensuring accuracy and timeliness.Key ResponsibilitiesManage and oversee all aspects of payroll processing, ensuring accuracy and...

Job SummaryMolina Healthcare is seeking a highly skilled Pharmacist, Utilization Management to join our team. As a key member of our pharmacy team, you will play a critical role in ensuring that our members have access to necessary prescription medications in a cost-effective and safe manner.Key ResponsibilitiesReview coverage determinations and appeals in a...

Job Summary:We are seeking a highly motivated and detail-oriented AP Specialist to join our dynamic finance team at Jobot. As an AP Specialist, you will play a pivotal role in maintaining the financial health and integrity of our organization.Key Responsibilities:Oversee and manage the entire accounts payable process, including invoice processing, payment...

Job SummaryWe are seeking a highly motivated and detail-oriented Accounts Payable Specialist to join our dynamic finance team at Jobot. As an AP Specialist, you will be responsible for managing and processing accounts payable, executing financial transactions, and preparing financial reports.Key Responsibilities:Oversee and manage the entire accounts payable...

Join Sevita as a Clinical SpecialistSevita is a mission-driven organization dedicated to making a positive impact in the lives of others. As a Clinical Specialist, you will play a vital role in providing services to individuals with intellectual and developmental disabilities. Your clinical and interpersonal skills will be utilized to create a supportive and...

Join Sevita as a Clinical SpecialistSevita is a mission-driven organization dedicated to making a positive impact in the lives of others. As a Clinical Specialist, you will play a vital role in providing services to individuals with intellectual and developmental disabilities. Your clinical and interpersonal skills will be utilized to create a supportive and...