Clinical Utilization Manager

Job SummaryAs a key member of the Medicine Journal team, the Clinical Utilization Manager will play a critical role in ensuring the efficient and effective management of patient care. This position requires strong clinical knowledge and experience in utilization management, with a focus on medical necessity and regulatory compliance.ResponsibilitiesConduct...

Job Summary:As a Clinical Utilization Manager at Medicine Journal, you will play a crucial role in ensuring the efficient use of healthcare resources. You will interact with interdisciplinary staff to complete the process of utilization management, ensuring that patients receive the necessary care while minimizing unnecessary costs.Education:Required:A...

Job Summary:As a key member of the Medicine Journal team, we are seeking a skilled Clinical Utilization Manager to join our team. This role will be responsible for collaborating with interdisciplinary staff to ensure efficient utilization of healthcare resources.Responsibilities:Conduct initial and concurrent reviews of patient records to determine medical...

About the Role: We are seeking a highly skilled Clinical Assistant to join our team at Global Channel Management. As a Clinical Assistant, you will play a critical role in supporting our Utilization Management and Care Management teams. Key Responsibilities:Screen incoming calls and/or faxes or other digital format and direct calls/faxes/other digital...

Job SummaryBlueCross BlueShield of Tennessee is seeking a Clinical Assistant to join our team. As a Clinical Assistant, you will play a critical role in supporting our utilization management and care management teams. Your primary responsibilities will include screening incoming calls and faxes, directing calls to the appropriate area, and identifying and...

Job Summary:Erlanger Health seeks a skilled Utilization Management Nurse to join our team. As a key member of our healthcare team, you will be responsible for reviewing patient records and collaborating with physicians to determine medical necessity of admissions, observations, and procedures.Responsibilities:Conduct initial and concurrent reviews of patient...

Job Summary:The Utilization Review Team Lead Certified is a professional nurse employed by Medicine Journal and is responsible for the oversight, support, and day-to-day processes and responsibilities of a team of Utilization Review RNs.Key Responsibilities:Design and implement an educational program based on nationally accepted best practices and...

Job Summary:The Utilization Review Team Lead RN is a professional nurse employed by Medicine Journal and is responsible for the oversight, support, and day-to-day processes and responsibilities of a team of Utilization Review RNs.Responsibilities include the design and implementation of an educational program based on nationally accepted best practices and...

Job Title: Clinical AssistantWe are seeking a highly skilled Clinical Assistant to join our team at BlueCross BlueShield of Tennessee. As a Clinical Assistant, you will play a critical role in supporting our utilization management and customer service departments.Key Responsibilities:Screen incoming calls and faxes to direct them to the appropriate...

Job Title: Licensed Practical Nurse Clinical SupervisorJob Summary:The LPN Clinical Supervisor is a key member of our healthcare team, responsible for the administration and application of all clinical nursing functions, procedures, and protocols. This role involves supervising clinical operations, direct patient care, and patient education, as well as...

Job SummaryA registered professional nurse employed by Erlanger Health is responsible for providing direct and indirect patient care. The Clinical Staff Leader formulates a plan and executes it with the oncoming staff leader as required by the department.Education and ExperienceRequired:Graduate from an accredited School of NursingClinical experience...

Oncology Clinic Registered Nurse Job SummaryThe Kettering Health Network is seeking a skilled Oncology Clinic Registered Nurse to provide high-quality patient care in a dynamic and compassionate environment. As a key member of our interdisciplinary team, you will utilize the nursing process to deliver safe and effective care to patients experiencing...

Job Summary:The Clinical Documentation Auditor/Educator at Medicine Journal will analyze and evaluate inpatient records to ensure accurate and appropriate representation of the documentation and utilization of acute care services.This role involves facilitation of appropriate diagnosis and procedure code assignment and physician documentation of care to...

Unlock Your Potential as a Clinical Pharmacist at Parkridge Medical CenterWe are seeking a highly skilled and dedicated Clinical Pharmacist to join our team at Parkridge Medical Center. As a Clinical Pharmacist, you will play a vital role in ensuring the safe and effective use of medications for our patients.Key Responsibilities:Assist in performing daily...

Job Title: Clinic SecretaryFulfill the goals of our organization and the needs of our patients by applying your skills to achieve results of a truly rewarding nature. Allow others to live more satisfying lives and your career to thrive.About Fresenius Medical Care North AmericaAs the global leader in dialysis healthcare, we offer exceptional opportunities to...

Job SummaryParkridge Medical Center is seeking a highly skilled Clinical Pharmacist to join our team. As a key member of our pharmacy department, you will be responsible for ensuring the safe and effective use of medications in our patients.ResponsibilitiesAssist in the preparation and dispensing of medications, including IV mixtures and compounding.Monitor...

Job Summary:A skilled Registered Nurse employed by Medicine Journal is responsible for collaborating with patients, families, physicians, and staff to develop and implement effective healthcare plans.Key Responsibilities:Assist patients and families in managing their healthcare plansCollaborate with interdisciplinary staff to complete the continuum of...

Job SummaryWe are seeking a highly skilled and experienced Clinical Nurse Manager to lead our East Wing 3 team at Erlanger Health System. As a key member of our leadership team, you will be responsible for planning, directing, and evaluating clinical practice, patient care, and operations of the department.Key ResponsibilitiesProvide leadership and direction...

About the RoleWe are seeking a skilled Clinical Staff Leader to join our team at Erlanger Health System. As a Clinical Staff Leader, you will be responsible for providing safe and effective patient care by utilizing evidence-based best practices.Key ResponsibilitiesUtilize hand-off communication and bedside shift report to effectively communicate with other...

Catholic Health Initiatives is seeking a dedicated and experienced Registered Nurse to fill the role of Clinical Educator. This position is responsible for leading Nursing Education within the CHI Memorial Health System, with a focus on onboarding and orienting new associates, developing and implementing education for individual units, and assessing and...