- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print... Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that the ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48… more
- Centene Corporation (Sacramento, CA)
- … 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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… 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 ... Blue Ash, OH office.** **PRIMARY PURPOSE** : To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- AmeriHealth Caritas (LA)
- …Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity ... all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN 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
- Commonwealth Care Alliance (Boston, MA)
- …and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM)… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location: Tulsa,… more
- University of Utah Health (Salt Lake City, UT)
- …+ Coordinate and communicate real-time staffing changes in conjunction with the Hospital Supervisor . + Review open shift requests and secure coverage as needed. ... care needs. + The role also involves proactive daily management to secure staff for open shifts to ensure...based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor 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
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …years of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and understanding of ... Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the...with special projects as directed or requested by the supervisor or department director. Performs Concurrent Review … more
- Mohawk Valley Health System (Utica, NY)
- Case Management Supervisor - Full Time - Days Department: CASE MGMT Job Summary The Case Management Supervisor is responsible for the oversight of the ... case management staff's authorization/coordination/ utilization and provision of member...direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full Time...SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member… 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 ... and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted...USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly… more
- CareFirst (Baltimore, MD)
- …Licensure. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient ... DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will...This role will assist leadership with the development and review of Care Management standards, program criteria,… more
- WMCHealth (Valhalla, NY)
- …the procedures specified in the Clinical Care Management Department through review of the Utilization and Discharge Planning Program at Westchester Medical ... Supervisor Of Nursing - Clinical Care Management Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management … more
- University of Southern California (Los Angeles, CA)
- The LCSW Care Coordination Supervisor is a leader with sound clinical skills and actively assists the Leadership in coordinating both clinical and operational ... duties. The Supervisor oversees departmental staff including Transplant Social Workers in an effective and efficient manner. This includes creating staff schedules,… more
- WEG Electric Corp. (Duluth, GA)
- Accounts Payable Supervisor / Management Accountant **Department:** Finance **Location:** Duluth, GA About the role: ... (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req\_id=3477150&source=3477150-CJB-0) The Accounts Payable (AP) Supervisor - Management Accountant will primarily oversee a small… more
- Albany Medical Center (Albany, NY)
- …and serves as the supervisor in the absence of the Laboratory Supervisor . Other critical aspects include project management , management of supplies ... to support the laboratory staff in daily operations. Develop and utilize management reports (workload, utilization , etc.) Establish departmental controls that… more