Clinical Review Coordinator
1 day ago
We are seeking a highly skilled Licensed Utilization Review Specialist to join our team at Elevance Health. As a key member of our clinical review team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care.
Key Responsibilities- Pre-Certification Reviews: Conduct thorough pre-certification reviews to ensure that our members receive the necessary care and services.
- Utilization Review: Conduct utilization reviews to ensure that our members receive the most appropriate and cost-effective care.
- Clinical Decision Making: Make sound clinical decisions based on medical necessity, clinical guidelines, and plan benefits.
- Communication: Develop and maintain strong relationships with healthcare providers, facilities, and internal stakeholders to ensure seamless communication and coordination of care.
- Education and Training: Educate members about plan benefits, contracted providers, and healthcare services.
- Education: High School Diploma or equivalent required; Associate's or Bachelor's degree in a related field preferred.
- Experience: Minimum of 2 years of clinical or utilization review experience and 1 year of managed care experience required.
- Licensure: Current active unrestricted license or certification as a LPN, LVN, or RN required.
- Compact License: Compact license preferred.
- Utilization Management Experience: Utilization management experience preferred.
- Medicaid Utilization Management Experience: Medicaid utilization management experience preferred.
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Clinical Utilization Review Specialist
1 week ago
Topeka, Kansas, United States Elevance Health Full timeJob SummaryWe are seeking a skilled Clinical Utilization Review Specialist to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesCollaborate with healthcare providers to collect clinical information required for...
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Clinical Utilization Review Specialist
1 week ago
Topeka, Kansas, United States Elevance Health Full timeAbout the RoleWe are seeking a highly skilled Clinical Utilization Review Specialist to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in ensuring that our members receive the highest quality care while also helping us to manage our healthcare costs.Key ResponsibilitiesReview and Approve Healthcare...
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Clinical Resource Coordinator
7 days ago
Topeka, Kansas, United States Klaton Consultants Full timeOverview The Clinical Resource Coordinator will collaborate with the Emergency Department and Resource Care Coordinator in various communities to facilitate the completion of essential tasks, including but not limited to: quarterly medication assessments, risk management evaluations, patient admissions and re-admissions, laboratory procedures (routine sample...
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Healthcare Quality Review Coordinator
2 weeks ago
Topeka, Kansas, United States State of Kansas Full timeEmployment Benefits Comprehensive medical, mental, dental, vision, and additional coverage Sick & Vacation leave Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave Paid State Holidays (designated by the Governor annually) Fitness Centers in select locations Employee discounts Retirement and deferred compensation programs ...
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Clinical Services Coordinator
2 weeks ago
Topeka, Kansas, United States Pathway Family Services LLC Full timePosition Overview:Join our dedicated team at Pathway Family Services LLC as a Clinical Services Coordinator. We are seeking a full-time professional who is passionate about making a difference in the lives of children and families.Sign-On Bonus: $5,000Qualifications:- Must be at least 21 years of age- Master’s degree in social work, professional...
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Vascular Care Clinical Coordinator
2 weeks ago
Topeka, Kansas, United States Ardent Health Full timePosition Overview:This role offers a competitive Sign-On Bonus of up to $20,000.00. We are seeking a full-time, day shift Clinical Navigator Registered Nurse specializing in vascular care.Commitment to Our Staff:At Ardent Health, we prioritize our employees' well-being. We provide comprehensive benefits including medical, vision, and dental insurance, health...
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Vascular Care Clinical Coordinator
2 weeks ago
Topeka, Kansas, United States Ardent Health Full timeOverview:This position offers a competitive Sign-On Bonus. We are seeking a full-time, day shift Clinical Navigator Registered Nurse specializing in Vascular Care.Why Choose Us:We prioritize our people and their well-being.Benefits Include: Comprehensive medical, vision, and dental insurance, health savings accounts, flexible spending options, competitive...
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Healthcare Operations Coordinator II
2 weeks ago
Topeka, Kansas, United States Elevance Health Full timeHealthcare Operations Coordinator IILocation: Kansas. This role operates in a hybrid model, combining remote work with office responsibilities. Candidates should ideally reside within a 50-mile radius of the Topeka, Kansas Elevance Health PulsePoint location.The Healthcare Operations Coordinator II plays a crucial role in delivering non-clinical assistance...
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Patient Care Coordinator
2 weeks ago
Topeka, Kansas, United States UKHS St. Francis Campus Full timePosition SummarySign-On Bonus Opportunity AvailableWe invite you to consider a rewarding role as a part-time Patient Care Coordinator in the Acute Care division at UKHS St. Francis Campus.Your Journey Begins Here:At our organization, we prioritize our employees' well-being. Here’s how we support our team:Comprehensive medical, vision, and dental insurance,...
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Healthcare Operations Coordinator II
2 weeks ago
Topeka, Kansas, United States Elevance Health Full timePosition Title:Healthcare Operations Coordinator IIJob Overview:The Healthcare Operations Coordinator II plays a pivotal role in supporting non-clinical functions within medical management operations. This position is designed for individuals who can manage complex inquiries and file assessments from both members and healthcare providers.Key...
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Clinical Support Specialist
1 week ago
Topeka, Kansas, United States Elevance Health Full timeJob SummaryWe are seeking a highly skilled Medical Management Specialist II to join our team at Elevance Health. This role will provide non-clinical support to medical management operations, handling complex file reviews and inquiries from members and providers.Key ResponsibilitiesGather clinical information regarding cases and determine the appropriate area...
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Clinical Support Specialist
3 days ago
Topeka, Kansas, United States Klaton Consultants Full timeJob SummaryThe Resource Nurse will work closely with the Emergency Department (ED) and Regional Care Coordination (RCC) teams to provide support and assistance in various tasks and initiatives. This role requires a strong clinical background and excellent communication skills to effectively collaborate with healthcare professionals and community staff.Key...
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Clinical Nurse Specialist
2 weeks ago
Topeka, Kansas, United States AdventHealth Full timeRegistered Nurse - Clinic Position at AdventHealthComprehensive Benefits and Perks for You and Your Family:Vision, Medical & Dental Coverage from Day OneStudent Loan Repayment AssistanceRecognized with Magnet status by the American Nurses Credentialing CenterOur Commitment to You:Joining AdventHealth means becoming part of a larger mission. It’s about...
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Vascular Care Clinical Coordinator
2 weeks ago
Topeka, Kansas, United States Ardent Health Full timeOverview:This position offers a competitive Sign-On Bonus of up to $20,000.00. We are seeking a full-time, day shift Clinical Navigator Registered Nurse specializing in Vascular Care.Commitment to Our Staff:At Ardent Health, we prioritize our employees' well-being. We provide comprehensive benefits including medical, vision, and dental insurance, a health...
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Cardiac Clinical Dietitian Professional
1 week ago
Topeka, Kansas, United States Stormont-Vail HealthCare Full timeJob Summary:Stormont-Vail HealthCare is seeking a skilled Cardiac Clinical Dietitian to join our team. As a key member of our healthcare team, you will play a vital role in providing high-quality patient care and education.Responsibilities:Obtain and review patient nutrition history and conduct comprehensive nutrition assessments to identify nutritional...
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Clinical Program Manager
3 days ago
Topeka, Kansas, United States Valeo Behavioral Health Care Full timeAbout the RoleValeo Behavioral Health Care is seeking a highly skilled Clinical Coordinator to join our team. As a Clinical Coordinator, you will play a critical role in providing clinical support and direction to our staff, ensuring the effective delivery of care to our clients.Key ResponsibilitiesProvide clinical oversight and input in the treatment plan...
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Clinical Laboratory Specialist
2 weeks ago
Topeka, Kansas, United States Stormont Vail Health Full timePosition OverviewReq16928Full-time - 12 Hour Night Shift (Includes Night Differential Pay)Rotating weekends and holidays requiredEducational RequirementsBachelor's Degree in Medical (Clinical) Laboratory Science, Biology, Chemistry, or a related discipline. MandatoryLicenses and CertificationsMedical Laboratory Scientist - ASCP Certification by AMT or NCA is...
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Healthcare Consultant II
5 days ago
Topeka, Kansas, United States Impresiv Health Full timeAbout the RoleWe are seeking a highly skilled Healthcare Consultant II to join our team at Impresiv Health. As a key member of our clinical operations team, you will play a critical role in providing comprehensive healthcare management services to our clients.Key ResponsibilitiesEvaluation and Case Management: Conduct thorough evaluations of referred...
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Clinical Program Manager
2 weeks ago
Topeka, Kansas, United States Center For Discovery logo Full timeThe Clinical Director plays a pivotal role in overseeing and managing the clinical components of our program. Key Responsibilities Ensures the quality and effectiveness of clinical services, proactively seeking opportunities for enhancement. Facilitates weekly treatment team meetings to promote effective communication and collaborative approaches in...
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Clinical Program Supervisor
2 weeks ago
Topeka, Kansas, United States Center For Discovery logo Full timeThe Clinical Director plays a pivotal role in overseeing and guiding the clinical operations of the program. Key Responsibilities Ensures the highest quality of clinical services within the program and proactively seeks opportunities for enhancement. Facilitates weekly treatment team meetings to promote effective communication, monitoring client...