- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 - $176,872.80… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation… more
- Hartford HealthCare (Torrington, CT)
- …*Job Summary* Under the Direction of the Inpatient Nurse Director & Social Work Supervisor , the Inpatient Psychiatric Utilization Review Social Worker will ... with the IP Psychiatry Patient Care Team to assure Utilization Review activities on a 17 bed...employees with an extensive benefits package consisting of: * * Medical and dental benefits* * *401(k) plan with employer… more
- The Cigna Group (Bloomfield, CT)
- …issues, implications and decisions. The Case Management Analyst reports to the Supervisor /Manager of Appeals and will coordinate and perform all appeal related ... appeals will include requests for decisions regarding denials of medical services as well as Part B drugs. The...accurately; e) prepare case files for submission to Independent Review Entity, which also include writing required case summary… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …optimize member care and ensure a constructive provider experience + Facilitate review process by communication with members/families, providers, medical staff ... BCBSMA utilization management process + Collaborate with members/families, providers, medical staff and/or other members of the treatment team to coordinate and… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Sharp HealthCare (San Diego, CA)
- …Do** The UM Care Coordinator, under the direct supervision of the Supervisor , Utilization Management Care Coordinators, prepares referral requests for outpatient ... service. This position is responsible for conducting retrospective claims review for services to determine the medical ...it related to the position.Bring to attention of the Supervisor , Utilization Management Care Coordinators, and UM… more
- University of Miami (Miami, FL)
- … review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . APP Supervisor - Medicine, Medical Oncology - Full ... medical directors, and other relevant stakeholders to assure appropriate utilization of all APPs. The Supervisor , Advanced Practice Providers provides… more
- Johns Hopkins University (Baltimore, MD)
- …Duties & Responsibilities** + Manage the daily administrative oversite of the medical provider practice. + Review and update provider's clinical protocols ... Surgical Scheduling Strongly Preferred. + Knowledge of JHU clinical system. Classified Title: Medical Office Supervisor Job Posting Title (Working Title): CO … more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by… more
- Cedars-Sinai (Tarzana, CA)
- …Los Angeles and beyond. **Req ID** : 3195 **Working Title** : RN Oncology Supervisor - Medical Oncology (CS Ventana Oncology Medical ) **Department** : ... **Job Description** The Supervisor , Clinical Operations Oncology RN is responsible for...arises. Duties and Responsibilities: + Assists in the development, review , and revision of standard operating policies and procedures… more
- Louisiana Department of State Civil Service (Reserve, LA)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4730645) Apply REGISTERED NURSE SUPERVISOR A Salary… more
- Children's Hospital & Research Center Oakland (Oakland, CA)
- **Position Summary:** The primary role is to supervise the Utilization Management, Surgery Registration, and Financial Counselors activities to insure a payor source ... the appropriate payors to insure all services provided are reimbursed. The Supervisor provides the necessary support and leadership to achieve departmental goals and… more
- Louisiana Department of State Civil Service (Monroe, LA)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... Registered Nurse Supervisor A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4726672) Apply Registered Nurse Supervisor A Salary… more
- Louisiana Department of State Civil Service (Jackson, LA)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... RN Supervisor A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4725546) Apply RN ...the Veterans' population of Louisiana through the provision of medical , restorative, and rehabilitative services in an atmosphere of… more
- Kepro (AR)
- …Clinical Director and Medical Director, the Supervisor , Dental Review oversees dental staff performing Utilization Management (UM) Reviews for Medicaid ... in the public sector. Acentra is looking for a Supervisor , Dental Review (Remote within Arkansas) to...experience. + Experience with State Medicaid Dental programs. + Utilization Management/Clinical Review experience. #LI-SD1 Why us?… more
- Dignity Health (Sacramento, CA)
- …proper utilization of FTE's, Quality Assessment and Improvement, utilization review , equipment ordering, safety in-services, staff development, staff ... Hospital is home to a 158 acute-care bed facility with 1120 employees 283 medical staff and 29 Emergency Department beds. Methodist Hospital also owns and operates… more
- CareFirst (Baltimore, MD)
- … medical -surgical or similar clinical experience OR + 5 years experience in Medical Review , Utilization Management or Case Management at CareFirst ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor (RN) directs and coordinates the accurate implementation of the clinical appeal process for… more
- City and County of San Francisco (San Francisco, CA)
- …customers regarding electronic system development, implementation, issues, and recommendations and utilization of best practices; + Work with the EHR implementation ... requirements; + Evaluate workflows and recommend re-engineering of processes around utilization of computerized applications, including the new EHR to improve the… more
- HCA Healthcare (Houston, TX)
- …implementor, and evaluator. Actively participates in the collaborative program which requires review of patient activities related to medical necessity of ... patient needs. + Accountable for reviewing, monitoring and reporting hospital utilization of resources through concurrent review according to pre-established… more