- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement,… more
- Centene Corporation (Sacramento, CA)
- …Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- University of Michigan (Flint, MI)
- Office Administration Senior Supervisor ( Hybrid ) **Early Site Maintenance** We are performing updates and maintenance to our applicant experience. As a result, ... **Job Detail** **Job Opening ID** 271200 **Working Title** Office Administration Senior Supervisor ( Hybrid ) **Job Title** Office Administration Sr Supr **Work… more
- CareFirst (Baltimore, MD)
- …County/Washington DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and ... a week-to-week basis, management may occasionally approve the onsite care management supervisor to perform limited functions telephonically, at its sole… more
- CareFirst (Baltimore, MD)
- …medical-surgical or similar clinical experience OR 5 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross ... of regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in processing appeals.… more
- AmeriHealth Caritas (LA)
- …Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity ... using InterQual and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care organization desired +… more
- Child Communication and Behavior Specialists (CA)
- …neurodiversity-affirming, and culturally inclusive environment. The Position We are seeking a Hybrid BCBA Supervisor & Clinical Consultant to join our team. ... conducted in clinics or client homes. As a BCBA Supervisor , you'll: + Deliver impactful caregiver-mediated treatment (CMT). +...and successful client outcomes. + Ensure at least 90% utilization of recommended treatment hours. + Deliver a minimum… more
- University of Utah Health (Salt Lake City, UT)
- … to reassign staff based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and Nursing Leadership in identifying ... are integral to our mission. EO/AA_ + The Staff Utilization Coordinator is responsible for providing healthcare operational support...care needs. + The role also involves proactive daily management to secure staff for open shifts to ensure… more
- Eversource Energy (Plymouth, MA)
- …productivity of district/substation operations\. Responsible for monitoring district performance through utilization analyses\. This is a hybrid role\. The first ... utilization and workload trends and productivity\. Keeps district/substation management informed of results\. + Identifies, develops and implements work process… more
- Sedgwick (Cincinnati, OH)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review **Join us in a hybrid capacity, combining remote work with ... Ash, OH office.** **PRIMARY PURPOSE** : To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. **ARE… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN 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
- Eversource Energy (Hartford, CT)
- …CPT, TN, J\-1, O\-1, etc\.\)\. _Eversource supports work\-life balance by offering hybrid schedules for certain roles\. Eligibility is based on job responsibilities, ... with the third day set by the employee and supervisor based on department needs\. These guidelines apply to...or should the policy change\._ The Senior Engineer, Asset Management will have the primary responsibility for ensuring that… more
- Pacific Medical Centers (Renton, WA)
- …Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health ... of Operations and USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Providence caregivers… more
- Cedars-Sinai (CA)
- …emphasis on visualization, efficiency, and automation required. Three (3) plus years of Management / Supervisor experience in a Healthcare IT team. Two (2) plus ... " list, which highlights hospitals that have excelled in the utilization of electronic functionalities, telemedicine, digital imaging, artificial intelligence and… more
- Eversource Energy (Manchester, NH)
- …CPT, TN, J\-1, O\-1, etc\.\)\. _Eversource supports work\-life balance by offering hybrid schedules for certain roles\. Eligibility is based on job responsibilities, ... Tuesdays and Wednesdays, with the third day set by the employee and supervisor based on department needs\. These guidelines apply to roles approved for remote… more
- Cedars-Sinai (Los Angeles, CA)
- …of service cash collections and cash flow, and provide efficient and appropriate utilization of resources. Acts as a resource for team members by assisting with ... and CSMC policies and procedures, performance feedback and evaluations, change management , and cost containment efforts. Responsible for the integrity of the… more
- Eversource Energy (Westwood, MA)
- …CPT, TN, J\-1, O\-1, etc\.\)\. _Eversource supports work\-life balance by offering hybrid schedules for certain roles\. Eligibility is based on job responsibilities, ... Tuesdays and Wednesdays, with the third day set by the employee and supervisor based on department needs\. These guidelines apply to roles approved for remote… more
- CVS Health (Cincinnati, OH)
- …product, and services offerings, as well as resolving any issues with respect to the utilization of the product. The position will be a part of a high performing ... probing questions, and demonstrating superior listening skills. + Document in the hybrid field sales integrated tech stack the call interactions, COIs, and lead… more
- Arizona Public Service (Phoenix, AZ)
- …and workplace evolution to inform investment decisions. Workplace Strategy & Space Management + Direct space planning, utilization , and move management ... Supervisor , Facilities Strategy and Planning Apply now "...enterprise growth and operational performance. Real Estate & Portfolio Management + Oversee real estate acquisitions, dispositions, and lease… more
- Guidehouse (San Marcos, CA)
- …Required** **:** None **What You Will Do** **_This position is classified under a Hybrid schedule consisting of two days working from any of the following offices of ... and three days working from home._** The **Hospital Project Supervisor PFS** is responsible for overseeing the daily operations...overseeing the daily operations of a project(s) and the management of the project staff inclusive of onsite Team… more
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