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Case Management Jobs
Nevada Licensed Utilization Review Clinician
A company is looking for a Utilization Review Clinician - BH. Key Responsibilities Evaluates member's treatment for mental health and substance abuse to ensure appropriateness of care Performs prior authorization and concurrent reviews related to mental health and substance abuse Provides
Nevada Licensed Utilization Review Clinician
A company is looking for a Utilization Review Clinician - BH. Key Responsibilities Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness Performs prior authorization reviews and concurrent reviews related to behavioral health services Analyzes
State Licensed Utilization Review Clinician
A company is looking for a Utilization Review Clinician to join their team in a full-time capacity. Key Responsibilities Review and coordinate clinical utilization and external payer expectations for patient admissions Serve as a clinical resource for the healthcare team regarding admission
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State Licensed Utilization Review Clinician
A company is looking for a Utilization Review Clinician to join their team. Key Responsibilities Review and coordinate clinical utilization and external payer expectations for patient admissions Act as a clinical resource for the healthcare team regarding admission appropriateness and continued
Minnesota Licensed RN Specialist
A company is looking for an RN Specialist in Complex Case Management. Key Responsibilities Engages members with high-cost, complex medical conditions through telephonic outreach Company clinical assessments Collaborates with the interdisciplinary care team to develop Company monitor comprehensive plans
Michigan Licensed Behavioral Health Clinician
A company is looking for a Licensed Behavioral Health Clinician for a remote telehealth position. Key Responsibilities Track treatment responses, monitor clinical symptoms, and facilitate patient education, referrals, and care coordination through EHR and other clinical tools Screen and assess
Georgia Licensed UM RN
A company is looking for a Centralized UM RN, Part Time. Key Responsibilities Provide centralized utilization management for patient care Collaborate with healthcare teams to ensure quality care delivery Monitor and evaluate patient outcomes to improve service efficiency Required
New York RN Nurse Case Manager
A company is looking for a Nurse Case Manager to work remotely in the USA. Key Responsibilities Develop proactive plans of care to enhance outcomes and overall wellness Conduct holistic assessments and evaluate members' needs using clinical tools and data Collaborate with stakeholders to address
Florida Licensed Utilization Review Clinician
A company is looking for a Utilization Review Clinician - ABA. Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services for medical appropriateness Performs prior authorization reviews to determine medical appropriateness in accordance
Licensed Behavioral Health Clinician
A company is looking for a Utilization Review Clinician - Behavioral Health. Key Responsibilities Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness Performs prior authorization and concurrent reviews related to behavioral health
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