Clinical Utilization Manager

About the Role:CVS Health is seeking a skilled Utilization Management Nurse Consultant to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in coordinating, documenting, and communicating all aspects of the utilization/benefit management program.Key Responsibilities:Utilize clinical skills to coordinate, document, and...

Bring Your Expertise to CVS HealthAt CVS Health, we're committed to delivering exceptional healthcare services that put our patients at the forefront. As a Utilization Management Nurse Consultant, you'll play a vital role in ensuring that our patients receive the best possible care.Key Responsibilities:Apply critical thinking and clinical expertise to make...

At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. As a Utilization Management Nurse Consultant, you'll play a critical role in transforming our culture and accelerating our ability to innovate and deliver solutions that make healthcare more personal, convenient, and affordable.Job SummaryThis is a...

Job SummaryCapital BlueCross is seeking a highly skilled Clinical Pharmacist to join our team. As a Clinical Pharmacist, you will be responsible for developing, maintaining, and evaluating pharmacy clinical initiatives and utilization management programs to ensure cost-effective and quality pharmaceutical services for our plan members.Key...

Job DescriptionVeolia North America is seeking a highly skilled Water Utility Program Manager to join our team. This role will be responsible for implementing and managing the Lead and Copper Rule (LCR) Program and the Cross Connection Control/Backflow Prevention Program in Pennsylvania and Delaware.The ideal candidate will have a strong background in...

Job SummaryCVS Health is seeking a skilled Clinical Nurse Consultant to join our team. As a key member of our Utilization Management department, you will play a critical role in coordinating, documenting, and communicating all aspects of our utilization/benefit management program.As a Clinical Nurse Consultant, you will utilize your clinical skills to apply...

Leadership Opportunity at BAYADA Home Health CareBAYADA Home Health Care is seeking a dedicated and experienced Registered Nurse (RN) to fill the position of Clinical Manager for our Harrisburg Office. As a Clinical Manager, you will be responsible for leading a team of field clinicians in delivering exceptional client service and quality clinical care while...

Job Summary:UPMC is seeking a Part-time Care Manager to coordinate the clinical and financial plan for patients. This role involves overall utilization management, resource management, discharge planning, and post-acute care referrals and authorizations.Responsibilities:Reviews medical records daily to ensure patients continue to meet LOC requirements and...

Penn State Health is seeking a skilled Clinical Case Manager to provide targeted case management services to child and adult mental health consumers with serious and persistent mental illness.Key Responsibilities:Conduct functional assessments to identify individualized service needsDevelop and implement service plans to improve quality of life and reduce...

Job Title: Clinical Manager - Home HealthBAYADA Home Health Care is seeking a Registered Nurse (RN) to fill the position of Clinical Manager for our Harrisburg Office home health office.This role involves leading a team of field clinicians, supervising client visits, and ensuring adherence to policies and procedures. The ideal candidate will have strong...

Care Manager Job DescriptionThe Care Manager at UPMC is responsible for coordinating the clinical and financial plan for patients. This involves performing overall utilization management, resource management, discharge planning, and post-acute care referrals and authorizations. The Care Manager works with a multi-disciplinary team in resource management,...

About the Role:We are seeking a highly skilled BCBA Clinical Manager to join our team at NeurAbilities Healthcare. As a key member of our clinical leadership team, you will be responsible for the management of clinical operations and quality assurance within your site location.Key Responsibilities:Directly supervise BCBAs in the practice and work...

Job SummaryAs a Pharmacist at Insight Global, you will play a vital role in assisting customers with their healthcare needs by filling prescriptions, providing clinical services, and delivering exceptional customer service. You will also supervise pharmacy associates and assume management responsibility as needed.Key ResponsibilitiesEnsure the accuracy and...

About the RoleWe are seeking a highly motivated and experienced Sales and Territory Manager to join our team at Philips. As a Sales and Territory Manager, you will be responsible for achieving sales of all applicable disposable products and services in assigned territory, assisting in advancing revenue and market position, and managing activity, development,...

About the RoleWe are seeking a highly skilled BCBA Clinical Manager to join our team at NeurAbilities Healthcare. As a key member of our leadership team, you will be responsible for the management of clinical operations and quality assurance within your site location.Key ResponsibilitiesDirectly supervise BCBAs in the practice and work collaboratively with...

Job SummaryThe Unit Director is responsible for leading and managing the Emergency Department to ensure an outstanding experience for patients and employees. This includes continuously improving the quality of patient care, creating a healthy workplace for staff, and overseeing clinical and administrative functions.Key ResponsibilitiesCollaborate with...

Job SummaryClinical Pharmacist Specialists play a vital role in patient care teams, focusing on safe and effective medication management for specialized patient populations.They provide direct patient-centered care, collaborate with interdisciplinary teams, and ensure clinical pharmacy services are integrated into the care process.Key responsibilities...

Acentra Health is seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a critical role in ensuring the quality and accuracy of medical records. Your expertise will be utilized to review medical records against established criteria, utilizing your clinical knowledge and critical thinking skills to determine medical...

Job DescriptionAs a Clinical Consultant - School Based Behavioral Health Specialist, you will share subject matter expertise and provide tailored information to various audiences. You will assist with a wide range of activities to benefit the children's behavioral health system.Clinical consultants may work independently on projects, collaborate with diverse...

Job Description:The Territory Sales Manager is responsible for driving sales within assigned territory and uncovering ways to pull through sales of core products amongst Ormco products and solutions portfolio.The ideal candidate will be the primary relationship builder and face of Ormco to the customer, the Orthodontist and his/her professional and clinical...