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Corewell HealthNew
Overview
Coordinates the submission of accurate data to insurance companies to ensure prompt payments and manages clinical reviews for third-party payers. Collaborates with the multidisciplinary care team to plan and implement patient transitions to home or transitional environments.
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Compensation
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Posted
New
Gainwell Technologies LLC
The Nurse Reviewer will perform clinical reviews to assess the appropriateness of care based on medical record documentation. This includes documenting findings, determining approvals, and assisting in training new Nurse Reviewers.
$65,000 - $75,000 / YEAR
3 days ago
St. Luke's University Health Network
The Case Manager provides comprehensive care for psychiatric patients by coordinating services from admission through discharge to improve quality of care and reduce length of stay. They facilitate multidisciplinary team meetings, manage insurance authorizations, and ensure safe discharge planning through community resource coordination.
11 days ago
The Case Manager provides comprehensive care for psychiatric patients by coordinating services from admission through discharge to improve patient outcomes. They facilitate multidisciplinary team meetings, manage insurance authorizations, and ensure safe discharge planning through community resource coordination.
Frontier Behavioral Health
The PACT Housing Specialist identifies and secures safe, affordable housing for individuals with serious mental illness using evidence-based practices. They serve as the primary liaison between clients, landlords, and housing subsidy programs to ensure long-term residential stability.
$26 - $32 / HOUR
15 days ago
Gotham Enterprises Ltd
Provide individual teletherapy sessions, conduct client intakes, and develop personalized treatment plans. Maintain accurate clinical documentation and ensure compliance with HIPAA and ethical licensing requirements.
$115,000 - $120,000 / YEAR
24 days ago
Provide individual therapy and mental health support to clients via virtual telehealth sessions. Responsible for conducting intake assessments, updating treatment plans, and maintaining accurate clinical documentation.
1 month ago
CDS Monarch, Inc.
The Registered Nurse will review case information and consult with care managers to ensure coordinated services for individuals with disabilities. They will also provide clinical recommendations, conduct home visits, and educate families on health conditions and medications.
$75,000 - $80,000 / YEAR
Hope Network
The Physical Therapist provides prescribed therapy services to patients with neurological disabilities, head injuries, and orthopedic needs. They also participate in interdisciplinary team meetings, conduct staff training, and manage clinical treatment plans.
Crisp Regional Health Services
The Case Manager Assistant supports the Utilization Review team by assessing patient social needs, coordinating safe discharge plans, and managing insurance authorizations. They also perform clinical reviews to ensure medical necessity and maintain accurate documentation within the hospital's electronic systems.
Health Care Service Corporation
This position oversees clinical reviews for Applied Behavior Analysis (ABA) services, acting as a subject matter expert on autism spectrum disorder cases and ABA services within the Behavioral Health clinical team. Responsibilities include conducting and documenting peer-to-peer reviews with external ABA providers, consulting on cases reviewed by appeals staff, developing team training, and presenting data to leadership.
$121,200 - $225,200 / YEAR
Kindred Healthcare
The Case Manager coordinates patient care through collaboration with the interdisciplinary team to ensure effective resource utilization and service delivery. They are responsible for conducting comprehensive assessments, facilitating safe discharge planning, and performing medical necessity reviews throughout the patient's stay.
$45 - $57 / HOUR
UHS
The Utilization Review Coordinator facilitates patient care and ensures optimal reimbursement by performing daily clinical reviews and securing treatment authorizations. They also collaborate with the multidisciplinary team to manage documentation, handle appeals, and report on utilization data trends.
2 months ago
The RN Case Manager coordinates patient care through the continuum, facilitating communication between the interdisciplinary team, physicians, and families. They are responsible for conducting medical necessity reviews, managing discharge planning, and ensuring cost-effective resource utilization.
$65 - $82 / HOUR
Allina Health
The intern is responsible for preparing, dispensing, and checking medications, obtaining medication histories, and ensuring the effective flow of pharmacy operations under pharmacist supervision. Key duties include medication preparation, inventory management, medication reconciliation, and providing clinical support services.
$25 / HOUR
PMHCC Inc.
The Behavioral Health Admin Resource Assistant is responsible for providing administrative and clerical support to the Behavioral Health Department. Key tasks include maintaining resource directories, coordinating meetings, and managing data entry and reports.
$41,841 - $53,935 / YEAR
AvaMed Workforce
The Temporary/Relief Primary Care Physician shall provide medical healthcare services for patients/youth consistent with established standards of medical practice and adhere to facility policies and procedures. Responsibilities include obtaining necessary treatment authorizations, managing patient transfers, and performing clinical reviews upon request to determine the quality of care delivered.
$210 / HOUR
High Point & Affiliated Organizations
The Utilization Review Nurse maintains licensure, ensures compliance with Federal Regulations like 42 CFR Part II and HIPAA, and manages utilization for all insured patients regarding inpatient treatment authorization. Duties include conducting clinical reviews with insurance companies for continued stay, updating staff on patient status, and obtaining necessary clinical information for concurrent reviews.
$32 - $38 / HOUR
3 months ago
Zing Health Holdings, Inc.
The Integrated Care Manager will conduct health risk assessments, coordinate care, and manage care for MAPD, C-SNP, and D-SNP members using approved screening criteria. This role involves following patients through care transitions, developing individualized plans of care, and serving as a patient advocate and resource for the care team.
The Referral Management RN is responsible for managing electronic referrals and coordinating care with sending facilities, patients, and families. This role also involves conducting thorough clinical reviews of medical records and collaborating with healthcare providers for safe patient placements.
