Clinical Utilization Specialist
15 hours ago
We are seeking a skilled Utilization Review Clinician to join our team at Monte Nido & Affiliates, LLC. As a Utilization Review Clinician, you will play a critical role in ensuring that our patients receive the highest level of care and support.
Key Responsibilities- Conduct thorough utilization reviews, peer reviews, and pre-certifications to ensure that patients receive the most appropriate level of care.
- Document reviews and coordinate with the clinical team, admissions, verifications, and billing to ensure seamless communication and care coordination.
- Develop and maintain relationships with payors to ensure that our patients receive the necessary authorization and support.
- Stay up-to-date with the latest payor trends, medical necessity criteria, and market developments to ensure that our patients receive the best possible care.
- Master's degree from an accredited program in social work, clinical counseling, nursing, nutrition, or equivalent.
- Independent State license or independent license eligible (LICSW, LMHC, LPC, Ph.D., RN, RD, LPN or equivalent active Independent Professional Licensure).
- 1+ years' experience in behavioral health utilization review.
- 2+ years' experience providing direct clinical care in a mental health setting, preferably with eating disorders in higher levels of care.
Monte Nido & Affiliates, LLC is a leading provider of treatment for eating disorders. We offer a comprehensive and personalized approach to care, blending medically sophisticated treatment with a supportive and nurturing environment. Our team is dedicated to providing the highest level of care and support to our patients and their families.
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Medical Assistant
6 days ago
Miami, Florida, United States Clinical Care Full timeJob SummaryClinical Care Medical Centers is seeking a highly skilled and compassionate Medical Assistant to join our team. As a Medical Assistant - Clinical Support Specialist, you will play a vital role in providing exceptional patient care and supporting our healthcare providers in a fast-paced clinical environment.Key ResponsibilitiesPre-Visit Planning:...
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Utilization Review Specialist
6 days ago
Miami, Florida, United States Monte Nido & Affiliates, LLC Full timeAbout the RoleWe are seeking a highly skilled Utilization Review Clinician to join our team at Monte Nido & Affiliates, LLC. As a Utilization Review Clinician, you will play a critical role in ensuring that our patients receive the highest level of care while also navigating the complexities of the healthcare system.Key ResponsibilitiesConduct thorough and...
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Utilization Review Specialist
6 days ago
Miami, Florida, United States Monte Nido & Affiliates, LLC Full timeJob SummaryMonte Nido & Affiliates, LLC is seeking a highly skilled Utilization Review Clinician to join our team. As a Utilization Review Clinician, you will play a critical role in ensuring that our patients receive the highest level of care by conducting thorough and comprehensive utilization reviews.Key ResponsibilitiesConduct utilization reviews, peer...
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Clinical Research Specialist
2 weeks ago
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Oncology Utilization Review Specialist
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Clinical Nutrition Specialist
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Clinical Nutrition Specialist
2 weeks ago
Miami, United States Public Health Trust of Dade Co Full timeClinical Nutrition Specialist The Public Health Trust of Dade County is seeking a dedicated Clinical Nutrition Specialist. Department: Nutrition Services Position Overview: The primary role of the Clinical Nutrition Specialist is to evaluate the dietary and nutritional requirements of patients across various age groups. This professional will develop and...
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Clinical Education Specialist
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Ocoee, Florida, United States Orlando Health Full timeJob SummaryOrlando Health is a leading healthcare system that provides comprehensive medical services to the community. We are seeking a highly skilled Learning Specialist I - Clinical Education to join our team.Key ResponsibilitiesDevelop and implement education programs to enhance clinical competence of team members.Coordinate the orientation process for...
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RN Utilization Management Specialist
3 days ago
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Clinical Documentation Specialist
2 weeks ago
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Clinical Nurse Specialist
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Clinical Documentation Specialist
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Clinical IT Specialist
2 weeks ago
Miami, United States Mudrasys Full timeAbout the Role:Mudrasys is seeking a highly motivated and tech-savvy Information Technology Graduate to join our team as a Clinical IT Specialist. In this role, you will play a critical part in guiding patients, nurses, doctors, and other staff in using our Pine App/Web portal and new clinical solutions.Key Responsibilities:Guide patients, nurses, doctors,...
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Utility Operator
1 week ago
Miami, Oklahoma, United States Nestle Purina PetCare Company Full timeAbout the RoleWe are a leading pet care company, committed to delivering high-quality products and exceptional customer service. As a Utility Operator - Manufacturing Specialist, you will play a critical role in ensuring the smooth operation of our production facilities.Key ResponsibilitiesSafely operate and maintain production equipment, including...
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Miami, Florida, United States Jackson Health Full timeDepartment: Jackson Memorial Hospital - Utilization Review Case Management (two openings)Address: 1611 NW 12 Ave, Miami, FL 33136Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote)Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of...
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Clinical Coordinator
4 months ago
Miami, United States Jackson Health System Full timeJOB DESCRIPTION Department: Jackson Memorial Hospital - Utilization Review Case Management (two openings) Address: 1611 NW 12 Ave, Miami, FL 33136 Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote) Why Jackson Memorial Hospital: Jackson Memorial Hospital is the flagship hospital for Jackson Health System and...
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Clinical Admissions Specialist
1 day ago
Sarasota, Florida, United States Sarasota Memorial Health Care System Full timeJob Summary:We are seeking a skilled Clinical Admissions Specialist to provide exceptional customer service and serve as the initial point of contact for individuals and families seeking mental health services.Key Responsibilities:* Conduct thorough risk assessments and evaluations to determine the most appropriate level of care* Coordinate the referral and...
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Clinical Application Template Specialist
3 weeks ago
Miami, United States Amerit Consulting Full timeOur client, a prominent Medical Center affiliated with a distinguished California Public Ivy university and one of the largest healthcare delivery systems in California, is in search of a skilled Clinical Application Template Specialist.________________________________________________Position: Clinical Application Template SpecialistLocation: San Francisco,...
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Miami, United States Jackson Health Full timeDepartment: Jackson Memorial Hospital - Utilization Review Case Management (two openings)Address: 1611 NW 12 Ave, Miami, FL 33136Shift Details: 8:00 am - 4:30 pm, Monday-Friday with weekends occasionally (primarily remote)Why Jackson Memorial Hospital:Â Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of...