- Centene Corporation (Tallahassee, FL)
- … utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines + Monitors ... valid Florida clinical license. **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members… more
- Lawrence General Hospital (Lawrence, MA)
- …team as well as the integrated care team and supports the case management / utilization review team on system-wide quality improvement/performance improvement ... Perform other duties as needed and assigned by your supervisor . REQUIRED EDUCATION AND EXPERIENCE: * Bachelor's Degree *...AND EXPERIENCE: * Bachelor's Degree * 1-2 year case management and utilization review experience… more
- Stanford Health Care (Palo Alto, CA)
- …Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care coordination and discharge ... leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by...on a rotating basis with other managers when on-call Supervisor is unavailable. + Develops and oversees relationships and… more
- BayCare Health System (St. Petersburg, FL)
- …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years...Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse +… 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
- 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 ... referral management system in OnBase, the document management system.Refer referral requests for review by...it related to the position.Bring to attention of the Supervisor , Utilization Management Care Coordinators,… 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
- Independent Health (Buffalo, NY)
- …day-to-day management of the RN staff of their assigned area (Case Management , Utilization Review and Population Health). This will include monitoring ... process; maintain a current and accurate database. + Provide high quality, professional utilization management services: (medical necessity review for Prior… 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)
- …lead or supervisory role. * Minimum of 2 years' experience in case management / utilization review , discharge planning, and Millman/InterQual criteria usage. * ... (UNICEF). We invite you to join our Scripps Memorial Hospital Encinitas Case Management team as a Supervisor of Case Management . As a supervisor of case… 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
- State of Colorado (Denver, CO)
- …utilization and storage regulations, programs, and related contracts. Review scientific literature, conference proceedings, technical work proposals, regulatory ... + Collecting from other team members. + Compiling into a navigable document management system and, if necessary, create review and retention periods. Deep… 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
- 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
- Children's Aid (Manhattan, NY)
- Social Work Supervisor (MST-CAN) 12/27/24Full Time--Manhattan Job ID: 007482 Description: Manhattan Family Services Center (60 Lafayette St, 3rd Floor) $72,000 - ... $78,000 Sign-On Bonus Eligible **Position Summary :**The**Social Work Supervisor **serves the combined roles of an Administrative Supervisor and Model … more
- Black & Veatch (Garner, NC)
- …maintenance agreements to optimize BV maintenance support. * Oversees the rental request, review , and closure to ensure efficient asset utilization and accurate ... **Fleet Maintenance & Logistics Supervisor - Hybrid** Date: Dec 25, 2024 Location:...of service level agreements, to ensure proper billing, maintenance, utilization , and asset review are documented, reviewed,… more
- CareFirst (Baltimore, MD)
- …5 years medical-surgical or similar clinical experience OR + 5 years experience in Medical Review , Utilization Management or Case Management at CareFirst ... **Preferred Qualifications:** + BS/MSN Degree. + 3 years supervisory experience Utilization Management , and Government Program experience with Appeals and… more
- HCA Healthcare (Houston, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits** Texas Orthopedic ... passion for patient care. Apply today for our Case Management Supervisor RN opportunity. **Job Summary and...needs. + Accountable for reviewing, monitoring and reporting hospital utilization of resources through concurrent review according… more
- Commonwealth of Pennsylvania (PA)
- …Learn more about us at www.dbhs.co . This opportunity is for a Program Supervisor to provide supervision and management of a Supports Coordination Organization ... County Casework Supervisor (Local Government) - Bedford County MH/ID Print...system. + Responsible for supporting all aspects of Incident Management . + Coordinate the dissemination and review … more
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