Utilization Management Nurse, Clinical Review Specialist

About The PositionBrighton Health Plan Solutions is dedicated to providing top-tier Utilization Management services. The Utilization Management Nurse is responsible for conducting daily assessments of medical necessity. This role reports directly to the Director of Clinical Programs.This job description is intended to outline the primary responsibilities and...

About The RoleBrighton Health Plan Solutions (BHPS) is dedicated to delivering exceptional Utilization Management services. The Utilization Management Nurse is responsible for conducting daily assessments of medical necessity. This role reports directly to the Director of Clinical Programs.This job description is intended to outline the primary...

Job OverviewPosition SummaryBrighton Health Plan Solutions, LLC is seeking a dedicated Utilization Management Nurse to provide essential services in the realm of healthcare management. This role is pivotal in conducting daily assessments of medical necessity and will report directly to the Director of Clinical Programs.Key ResponsibilitiesPerform utilization...

Position OverviewBrighton Health Plan Solutions is seeking a dedicated Utilization Management Nurse specializing in Prior Authorization. This role involves conducting medical necessity evaluations on prior authorization submissions in alignment with established national guidelines, contractual obligations, and member benefit coverage while operating in a...

About The PositionBrighton Health Plan Solutions is dedicated to providing exceptional Utilization Management services. The Utilization Management Nurse - Prior Authorization is responsible for conducting medical necessity evaluations on prior authorization submissions in line with national guidelines, contractual obligations, and member benefit coverage...

Position OverviewBrighton Health Plan Solutions is seeking a dedicated Utilization Management Nurse specializing in Prior Authorization. This role involves conducting assessments of medical necessity for prior authorization requests, ensuring compliance with established national standards and contractual obligations while working remotely.Key...

About The PositionBrighton Health Plan Solutions (BHPS) offers comprehensive Utilization Management services to its clients. The Utilization Management Nurse is responsible for conducting daily assessments of medical necessity. This role reports directly to the Director of Clinical Programs.This job description is intended to provide a general overview of...

Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Areas of focus includes Peri-Operative area and Emergency Department, although covering other inpatient and points of entry may be required. Completing special requests for timely...

Job Summary:We are seeking a highly skilled and compassionate Clinical Support Specialist to join our team at UNC Health Care. As a Clinical Support Specialist, you will play a vital role in providing exceptional patient care and support to our patients and families.Responsibilities:Assist healthcare providers with routine examinations and procedures, as...

Job SummaryWe are seeking a highly skilled and detail-oriented Clinical Support Specialist to join our team at UNC Health Care. As a Clinical Support Specialist, you will play a vital role in providing exceptional patient care and supporting our healthcare team.Key ResponsibilitiesAssist physicians and other healthcare providers with routine examinations and...

Shift InformationFull Time Monday - FridayDay shift: 7:00am - 3:30pm At Duke Health, we are dedicated to providing compassionate care that transforms the lives of our patients, their families, and the wider community. About Duke Regional HospitalJoin us in pursuing your passion for healthcare at Duke Regional Hospital, a leading facility in the...

Job Overview**This position is full-time and requires onsite presence. The successful candidate will collaborate with a skilled and dynamic team at Wellsense. Employees are offered competitive compensation, annual bonuses, and eligibility for sales commissions.** About WellsenseFounded in 2011, Wellsense developed the VŪ system with the aim of eradicating...

About Duke Health:At Duke Health, we are dedicated to providing compassionate healthcare that positively impacts the lives of our patients, their families, and the broader community. Overview of Duke University Hospital:Duke University Hospital, located in Durham, North Carolina, is renowned for its excellence in patient care and is consistently recognized...

Position Overview:This role is eligible for our Nursing Support Incentive Program, which offers $5,000 distributed over a three-year commitment.About the Role:The Clinical Support Specialist II is essential in assisting healthcare professionals in delivering patient care, managing patient transport, setting up and maintaining patient rooms, and executing...

Join a diverse and inclusive organization dedicated to enhancing the health and wellness of the communities we serve.Overview:A Clinical Practice Specialist (CPS) operates as a vital member of the multidisciplinary healthcare team, adhering to the privileges sanctioned by the credentialing committee to deliver exceptional, cost-efficient care to patients...

Job OverviewPosition SummaryBrighton Health Plan Solutions (BHPS) is seeking a dedicated Nurse Case Manager to oversee and implement case management services for our clients. This role is essential in ensuring that our members receive the highest quality of care while adhering to established guidelines and regulations.Key ResponsibilitiesEnsure compliance...

Job OverviewPosition SummaryBrighton Health Plan Solutions (BHPS) is seeking a dedicated Nurse Case Manager to oversee and enhance our case management services. This role involves the management of client cases, ensuring that our members receive the highest quality of care. The Nurse Case Manager will report directly to the Case Management Manager and will...

Incentive Program: This role is eligible for our Nursing Support Incentive Program, which includes a total of $5,000 distributed over a three-year commitment.Position Overview:The Clinical Support Specialist II (combining Nursing Assistant II and Clerical duties) is required for the GI Surgery Acute Care Unit. This unit is dedicated to providing...

Job OverviewPosition SummaryBrighton Health Plan Solutions (BHPS) is seeking a dedicated Nurse Case Manager to oversee and enhance our Case Management services. This role involves the comprehensive management of patient cases, ensuring that each member receives tailored care. The Nurse Case Manager will work under the supervision of the Case Management...

Position OverviewJoin a diverse and inclusive organization dedicated to enhancing the health and wellness of the communities we serve.Role Summary:The Advanced Clinical Nutrition Specialist collaborates with a multidisciplinary healthcare team to deliver evidence-based medical nutrition therapy that aligns with patient-centered medical objectives. Key...