Manager, Medical Review (RN Manager)
Nashville, Tennessee
BlueCross BlueShield of South Carolina
Internal Reference Number: R1045630 Summary Oversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards, and local, state, and federal laws and reg...
3d
| Job Type | Full Time |
1099 Physician Reviewer- Psychologist
West Des Moines, Iowa
This position is primarily responsible for conducting medical necessity reviews, as well as appeals and peer to peer discussions across the business unit portfolio of contracts. The incumbent is responsible for completing all reviews and ap...
3d
| Job Type | Full Time |
Manager of Clinical Pharmacy Services - Willowbrook - Houston, Tx
Houston, Texas
US Oncology Network-wide Career Opportunities
Overview Texas Oncology is looking for a Manager of Pharmacy Services to join our team! This position will support and work at our Willowbrook location in Houston, Texas. In the vibrant Willowbrook area of Northwest Houston, healing meets c...
3d
| Job Type | Full Time |
DEPUTY STATE LONG-TERM CARE OMBUDSMAN - 70552
Nashville, Tennessee
Executive Service DEPUTY STATE LONG-TERM CARE OMBUDSMANDepartment of Disability and AgingNashville, TNSalary: $5,591.00 - $8,915.00 MonthlyClosing Date: 09/04/2025 This position is designated as Work from Home. For more information, visit t...
3d
| Job Type | Full Time |
Poughkeepsie, New York
Job Details Job Location Poughkeepsie, NY Position Type Full-Time Salary Range $24.28 - $26.20 Hourly Travel Percentage Up to 50% Job Shift Day Join Our Mission The Children Health Home Care Manager is responsible for core services of hea...
3d
| Job Type | Full Time |
AVP Patient Care Services - Reynolds Memorial Hospital
Glen Dale, West Virginia
Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important inform...
3d
| Job Type | Full Time |
Springfield, Illinois
Description The person in this position will be responsible for all day-to-day operations and clinical activity for the Department of Internal Medicine's Dermatology, Infectious Disease and Rheumatology ambulatory clinics. This position wil...
3d
| Job Type | Full Time |
Director of Pharmacy, General Manager
Owensboro, Kentucky
Owensboro Health Regional Hospital Director of Pharmacy, General Manager - Specialty Pharmacy Owensboro, KY CPS Solutions is seeking a proven leader to help build and operate a world class specialty pharmacy program to service our patients ...
3d
| Job Type | Full Time |
Manager, Behavioral Health Care Management
Woodland Hills, California
Your Role The Manager Care Management-Behavioral Health will report to the Senior Manager Care Management - Behavioral Health. The role of Manager, Care Management - Behavioral health will be critical to the success of Blue Shield of Califo...
3d
| Job Type | Full Time |
Utilization Management Nurse, Senior
San Diego, California
Your Role The Utilization Management Prior Authorization team accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Utilization Management Nurse...
3d
| Job Type | Full Time |