- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical ... and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
- AmeriHealth Caritas (LA)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...home healthcare or a medical office setting. + Previous prior authorization experience is required.; + Proficiency in Electronic… more
- Dignity Health (Rancho Cordova, CA)
- …Summary:** Under the guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is responsible and accountable ... sets (Medicare Guidelines InterQual Health Plan Benefit Interpretation Guidelines and Medical Management Policies and DHMF Utilization Management guidelines… more
- Mohawk Valley Health System (Utica, NY)
- RN Supervisor Case Management - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Supervisor Case Management - SNH is responsible ... for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision and… more
- Ellis Medicine (Schenectady, NY)
- + The Supervisor of Case Management and Social Work (CMSW) assists with the daily operations of the Department. This person can assist with the hiring and ... of stay (LOS) and cost per case through resource management . + The Supervisor of CMSWS is...CMSWS assist with providing the link between compliance, clinical management , patient progression, gathering and reporting of utilization… more
- Molina Healthcare (Milwaukee, WI)
- …Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… more
- AdventHealth (Shawnee, KS)
- …at our hospital in Shawnee Mission, Kansas. **The role you'll contribute:** The Care Management Supervisor is under the general leadership of the Care ... operations and supervision of team members in the Care Management department. The Care Management Supervisor...action plans + Balances schedules to meet department needs prior to posting + Communicates changes to expected schedule… more
- Lactalis American Group Inc. (Londonderry, NH)
- … of maintenance planning and scheduling concepts. + Demonstrated understanding and prior utilization of storeroom management concepts. + Demonstrated ... Maintenance Supervisor Londonderry, NH (http://maps.google.com/maps?q=10+Burton+Drive+Londonderry+NH+USA+03053) Job Type Full-time Description...understanding and prior utilization of maintenance best practices. +… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse!Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ... Working under the general supervision of the Director and/or Manager/ Supervisor of Medical Management , and in collaboration...activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management … more
- Ventura County (Ventura, CA)
- Dietary Services Supervisor Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4920341) Apply Dietary Services Supervisor Salary $73,582.75 - ... schedules and assignments and sets priorities for the department to ensure maximum utilization of personnel to provide adequate coverage in processing the work; +… more
- ChenMed (Winter Park, FL)
- …license required if available in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital ... we need great people to join our team. The Supervisor , Intensive Community Care, RN is a multi-market leadership...serve as coach, mentor/trainer to all members of care management team, giving guidance in best practices, troubleshooting to… more
- BayCare Health System (Lakeland, FL)
- …BayCare HomeCare!** Explore a Rewarding Career with BayCare HomeCare as a Home Care Supervisor , RN. At BayCare, we are proud to be one of the largest employers ... day! Join our leadership team as a **Home Care Supervisor , RN** ensuring that our team members meet all...area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care… more
- V2X (Columbus, GA)
- …challenges with integrity, respect, responsibility, and professionalism. The Maintenance Supervisor (Shop A) is responsible for planning, coordinating, and ... repair in alignment with contract requirements and mission priorities. The Supervisor effectively manages personnel, repair parts, facilities, and tools to ensure… more
- Children's Home Healthcare (Albuquerque, NM)
- …have excellent communication skills and willing to travel to patient homes + Utilization Management Experience + Reliable transportation for patient visits + ... Home Healthcare is now hiring for a RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in...Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of… more
- WellSense (Boston, MA)
- …closely with leaders and staff from other teams and departments, including BH Care Management , BH Utilization Management , medical Care Management , and ... Supervisor of BH Clinical Support WellSense Health Plan...) is responsible for the daily operations and performance management of the Behavioral Health Clinical Support Team. This… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …of contact for the National HUD-VASH Program, VISN and VACO. The HUD-VASH Supervisor is responsible for direct Clinical Case Management /referral services in ... work assignment and review, as well as administrative and personnel management functions relative to the staff supervised. Incumbent observes workers' performance;… more
- NC Department of Transportation (Johnston County, NC)
- Transportation Supervisor I/IMAP Print (https://www.governmentjobs.com/careers/northcarolina/jobs/newprint/5022162) Apply Transportation Supervisor I/IMAP ... Date 07/29/2025 Closing Date 8/5/2025 11:59 PM Eastern Job Class Title Transportation Supervisor I Position Number 60018023 Section Division 4 - IMAP Salary Grade… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …all clinical and other patient care areas involved with the services. The HUD-VASH Supervisor is to provide clinical case management and supportive services to ... on the HUD Prioritization Notice, are admitted to case management to support the ongoing effort to end Veteran...improve Veteran's health and mental health needs. As the Supervisor , the incumbent assists in planning, establishing, and implementing… more
- Molina Healthcare (Savannah, GA)
- …and comply with CMS guidelines. These staff may also be involved in providing utilization management / prior authorization services as needed. * Supervises the ... those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy… more