- 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
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Health Care (SHC)? - Recognized as a top Academic Medical Center globally! - Ranked No. 10 on the...leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …processing and managing all in-patient and out-patient claims from a medical standpoint to ensure proper administration of contractual limitations and exclusions ... to include medical necessity, while maintaining compliance with regulatory guidelines. Responsible...license.required + Case Mgmt/Social Services\CPUR - Cert Prof Util Review Must be attained within first 24 months in… 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
- 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
- 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 ... REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4738991) 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 (Jennings, LA)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... REGISTERED NURSE SUPERVISOR A - DAY/EVENING Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4740025) Apply REGISTERED NURSE SUPERVISOR A… 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/4736880) Apply RN ...the Veterans' population of Louisiana through the provision of medical , restorative, and rehabilitative services in an atmosphere of… 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
- 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
- Children's Home Healthcare (Albuquerque, NM)
- …authorizations for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional ... Home Healthcare is now hiring for a RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in...on a 60 days basis per company policy. 9. Review /approve plan of care and all related documents prior… more
- Commonwealth Care Alliance (Boston, MA)
- …This panel of patients incorporates the care of individuals with significant medical , behavioral, and social complexities that require intensive care management and ... Reporting to an APC Manager within our Community Intensive Care Programming, the Supervisor , CIC Clinical Nursing is responsible for the oversight of clinical care… more
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