Clinical Utilization Management Specialist

Job Summary: We are seeking a skilled Clinical Utilization Specialist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in ensuring the quality and appropriateness of care for our members. Key Responsibilities: Perform clinical reviews and assessments of care related to mental health and...

Job Summary: We are seeking a highly skilled Nurse III to join our team as a Managed Care Nurse Analyst - Clinical Review. This senior-level position reports to the Acute Care Utilization Review Unit's (ACUR) Managed Care Clinical Review Manager. As a key member of our team, you will perform complex assessments and analyses of Medicaid MCO utilization...

Job Summary:The Utilization Manager will be responsible for conducting utilization reviews, granting authorizations, and monitoring compliance with various contracts entered into by Integral Care and Tejas Behavioral Health. This includes contracts with departments of the State of Texas, the City of Austin, Travis County, and managed care health plans. The...

Job Summary: We are seeking a skilled Utilization Manager to join our team at Integral Care. As a Utilization Manager, you will be responsible for conducting utilization reviews, granting authorizations, and monitoring compliance with various contracts entered into by Integral Care and Tejas Behavioral Health.Key Responsibilities:Conduct utilization reviews...

About the RoleWe are seeking a highly skilled Dishwasher Utility Specialist to join our team at Luby's.Key ResponsibilitiesWash and sanitize dishes, glassware, utensils, and potsMaintain cleanliness of kitchen and dining areasSweep and mop floors

Pain Specialist of America LLC Job DescriptionWe are seeking a highly skilled Medical Assistant to join our team at Pain Specialist of America LLC. As a Medical Assistant, you will play a vital role in providing exceptional patient care and supporting our healthcare professionals in a fast-paced environment.Key Responsibilities:Prepare for daily clinic...

Transforming Healthcare with CompassionCVS Health is seeking a dedicated and compassionate Clinical Appeals Specialist to join our team. As a key member of our healthcare team, you will play a vital role in reviewing and resolving clinical appeals, ensuring that our members receive the best possible care.Key Responsibilities:Review and interpret clinical...

About the Role:Evolent Health is seeking a skilled Utilization Management Lead to join our team. As a key member of our Clinical Operations team, you will be responsible for supervising the operational productivity of our Utilization Management nurses and ensuring compliance with regulatory standards.Key Responsibilities:Provides day-to-day direction and...

Job Summary:Centene Corporation is seeking a skilled Clinical Review Specialist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in ensuring the medical appropriateness of care and services related to mental health and substance abuse.Key Responsibilities:Perform clinical reviews and assessments...

Job Title: Sr. EHS Specialist, Utility OperationsThe Sr. Environmental, Health, and Safety (EHS) Specialist, Utility Operations and Maintenance plays a pivotal role in driving EHS process excellence, regulatory compliance, and overall risk reduction throughout Tesla's Utility Operations within North America. This position supports the development and...

Job Summary:Farnsworth Group is seeking a skilled Civil Engineer - Utilities Specialist to join our team. As a key member of our Energy & Utility Group, you will work on the planning, drafting, design, permitting, and construction administration of telecommunications and utility projects. Key Responsibilities: Review roadway plans to identify conflicts with...

Are you a detail-oriented medical laboratory professional with a passion for delivering high-quality patient care? We're seeking a Clinical Laboratory Histology Technician to join our team at Clinical Pathology Laboratories.As a key member of our front line of healthcare professionals, you'll play a vital role in the patient care process, performing...

Job SummaryWe are seeking a highly skilled Registered Nurse RN Outpatient Case Manager to join our team in Austin, Texas. As a member of our Optum Care Delivery team, you will play a critical role in making healthcare better for everyone.About the RoleThe Nurse Case Manager will be responsible for patient case management for longitudinal engagement,...

Job Title: Clinical Compliance SpecialistAt Women's Health and Family Planning, we are seeking a highly skilled Clinical Compliance Specialist to join our team. This role is responsible for monitoring and overseeing the Title X Family Planning Project, ensuring effective and high-quality care while working with sub-recipient agencies in response to quality...

Job SummaryCVS Health is seeking a highly skilled Clinical Pharmacist to join our team as a Prior Authorization Specialist. As a Clinical Pharmacist, you will play a critical role in evaluating and reviewing prior authorization requests, rendering coverage determinations based on clinical criteria and plan design. Your expertise will be essential in...

GENERAL DESCRIPTION As the state risk management specialist, the Executive Director of the Office is responsible for supervising the development and administration of a system of risk management for the state. The Office's performance measures include the goal to manage costs for covered state entities arising from the risk of loss through the delivery of...

Job Title: Clinical Outreach SpecialistAt Infinite Recovery LLC, we are seeking a highly motivated and experienced Clinical Outreach Specialist to join our team. This role will be responsible for driving growth and referrals in the Dallas Ft. Worth and Houston regions, focusing on substance abuse treatment and behavioral health services.Key...

Job SummaryThe Good Samaritan Society is seeking a skilled Nurse Manager/Infection Control Specialist to join our team. As a Clinical Care Leader, you will be responsible for utilizing the nursing process to provide individualized care to our residents. You will collaborate with inter-professional colleagues to plan, implement, and evaluate care, and...

Job Title: Clinical SpecialistRegency Integrated Health Services is seeking a highly skilled Clinical Specialist to join our team.Job Summary:The Clinical Specialist will serve as an advisor, trainer, educator, and auditor, assisting and supporting the facility Administrator and Director of Nursing. The ideal candidate will have a strong background in...

Pain Management Nurse Job SummaryWe are seeking a highly skilled and compassionate Pain Management Nurse to join our team at Pain Specialists of America LLC. As a key member of our healthcare team, you will be responsible for providing exceptional patient care and support to our patients undergoing pain management procedures.Key Responsibilities:Assist...