- 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
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Supervisor of Utilization Management has an important role in a high-profile group tasked with implementing system-wide improvements and ... operational processes to ensure optimal and compliant utilization review strategies. Under minimal supervision from the Manager the Supervisor is responsible… 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...document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria,… more
- AmeriHealth Caritas (Washington, DC)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets ... Utilization Management Reviewer reports to the Utilization Management Manager. * Conducts timely clinical decision review for services requiring… 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
- 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
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Molina Healthcare (Milwaukee, WI)
- …team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management activities ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… 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
- Novant Health (Wilmington, NC)
- …day supervision, operations, monitoring ongoing quality, productivity, and efficiency for both Utilization Review and Case Management activities. Is ... Job Summary The Case Management Supervisor is responsible for day...preferred. + Additional Skills Required: Current practice in case management / utilization review ; regulatory/governing standards, policies,… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- …position located in Norwich, CT. The Case Management Supervisor oversees that requirements are ... Developmental Services Supervisor Of Case Management Hybrid Recruitment...training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the… 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...as needed + Participates in hospital/medical staff meetings to review patients meeting criteria related to high dollar/ extended… more
- Kaleida Health (Williamsville, NY)
- …Office Suite and Outlook. 2 years of experience In any combination of: case management , home care and utilization review preferred. Knowledge of and ... **Patient Management Supervisor ** **Location:** Millard Fillmore Suburban **Location of Job** : US:NY:Williamsville **Work Type** : Part-Time **Shift 1** **Job… more
- Dignity Health (Rancho Cordova, CA)
- …working knowledge of Utilization Management Working knowledge of the Utilization Management review processes, and regulatory requirements. Must have ... the guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is...experience required in health plan/UM operations, Acute or subacute utilization review . - Graduate of an accredited… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates the activities of Inpatient Management Clinical ... as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care...and/or Compact State Licensure. **Experience:** 5 years experience in Utilization Management or Case Management … more
- Vail Resorts (Park City, UT)
- …Referral Program To Learn More, please review the Benefits Eligibility Summary (https://jobs.vailresortscareers.com/content/Perks-and-Benefits/?locale=en\_US) **Job ... growth of the supervisory team + Ensures consistency of Supervisor actions, consistency of EOS reviews, adherence to SOP's,...on duty in the absence of the Location Manager ** Management ** Staffing and Scheduling + Assists Location manager in… 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 ... 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
- Mitsubishi Chemical Group (Mesa, AZ)
- …Accountabilities + Management of a Team: As the Operations Planning Supervisor you will lead a team of Production Control Coordinators to ensure seamless ... **Operations Planning Supervisor (2126)** + Title:Operations Planning Supervisor ...to ensure dates and planning is appropriate. + Resource Management : Coordinate with production managers to allocate resources effectively,… more