- Centene Corporation (Cheyenne, WY)
- …Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- Sharp HealthCare (San Diego, CA)
- …Will Do** The UM Care Coordinator, under the direct supervision of the Supervisor , Utilization Management Care Coordinators, prepares referral requests for ... managed care, as it related to the position.Bring to attention of the Supervisor , Utilization Management Care Coordinators, and UM Manager, areas of UM… more
- Centene Corporation (Tallahassee, FL)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... adherence to performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH care member issues related to BH… more
- UCLA Health (Los Angeles, CA)
- …Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff ... schedules to efficiently handle incoming referrals and phone call volume. You will develop workflows, desktop procedures, forms, training materials, and protocols for achieving team objectives and key performance indicators. You will hire and train… more
- WellSpan Health (York, PA)
- …peer cases for need of retrospective external appeal-and funnel those cases to the Supervisor of Utilization Management for expedition. + Reviews cases ... Management staff. Duties and Responsibilities Essential Functions: + Renders utilization management determination in accordance with State and Federal… 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 ... purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling all administrative and… more
- Hackensack Meridian Health (North Bergen, NJ)
- …serve as a leader of positive change. The ** Supervisor , Care Management ** integrates and coordinates utilization management , care coordination, discharge ... acute care setting. + Familiar with hospital resources, community resources, and/or resource/ utilization management . + Care coordination, case management or… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …medical necessity criteria and BCBSMA policies and procedures + Focus on efficient utilization management with emphasis on discharge planning + Understand and ... to obtain and/or share information relating to benefits and the BCBSMA utilization management process + Collaborate with members/families, providers, medical… more
- Stanford Health Care (Palo Alto, CA)
- …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... on a rotating basis with other managers when on-call Supervisor is unavailable. + Develops and oversees relationships and...+ Knowledge of principles and best practices of case management , utilization review, social work, care coordination… more
- Lawrence General Hospital (Lawrence, MA)
- …advisor and healthcare team supports all administrative tasks/responsibilities for utilization management and revenue integrity cycle processes. Interacts ... goal of maintaining high-quality cost-effective care. The URS works collaboratively with utilization management staff to obtain information from clinical reviews… more
- Helio Health Inc. (Syracuse, NY)
- …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
- BayCare Health System (St. Petersburg, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.… more
- State of Colorado (Pueblo, CO)
- … and Quality Management QAPI supervisor + As part of the utilization management program, this position may be asked to participate in various aspects of ... + Behavioral health experience + Experience investigating occurrences + Prior utilization management experience + Experience in writing professional reports… more
- State of Massachusetts (Brockton, MA)
- …Health's Brockton Multi Service Center (BMSC) is seeking an experienced Adult Case Management Supervisor (Human Service Coordinator II) to join the team. The ... Adult Case Management Supervisor will: orient, train and provide...compliance with DMH Regulations, policies, and procedures. * Conduct utilization management reviews as well as audit… more
- AdventHealth (Kissimmee, FL)
- …Dialysis, Laboratory, and Imaging services. **The role you'll contribute:** **The Care Management Supervisor is under the general leadership of the Care ... and performing the daily operations and supervision of team members in the Care Management department.** **The Care Management Supervisor is responsible for… more
- Scripps Health (San Diego, CA)
- …Children's Fund (UNICEF). We invite you to join our Scripps Memorial Hospital Encinitas Case Management team as a Supervisor of Case Management . As a ... or supervisory role. * Minimum of 2 years' experience in case management / utilization review, discharge planning, and Millman/InterQual criteria usage. *… more
- Independent Health (Buffalo, NY)
- …a current and accurate database. + Provide high quality, professional utilization management services: (medical necessity review for Prior Authorization, ... and concurrent review). + Prompt, courteous, and error free in performing utilization management functions. + Maintain quality of reviews and documentation… more
- City of Reno, NV (Reno, NV)
- Fleet Management Supervisor Print Subscribe Class Title Fleet Management Supervisor Class Code 3775 Salary $82,700.80 - $116,438.40 Annually + Definition ... Inspect work in progress and upon completion; detect and correct inefficient utilization of staff and equipment; ensure that work conforms to specifications and… more
- Schwan's Company (Salina, KS)
- …can belong, contribute, and thrive, visit www.schwanscompany.com We are hiring a Maintenance Supervisor on 3rd Shift in our Salina, KS-based Tony's pizza plant. This ... Supervisor provides technical, process and people leadership for assigned...strategy. This role is a key leader in the utilization of the Asset Optimization elements, specifically Planning and… 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 ... daily admissions and coordinates any clinical payer concerns with the Utilization management department. Demonstrates overall improved Revenue Cycle performance… more
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