- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...implemented for compliance, as needed. + As a unit supervisor at the LA General Medical Center: + Has… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… 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)
- …system-wide improvements and operational processes to ensure optimal and compliant utilization review strategies. Under minimal supervision from the Manager ... GENERAL SUMMARY: The Supervisor of Utilization Management has an...GENERAL SUMMARY: The Supervisor of Utilization Management has an important role in a...the Supervisor is responsible for monitoring productivity and ensuring the… more
- AmeriHealth Caritas (LA)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... **Responsibilities:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... ON BONUS** **Role Overview:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization ...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Current driver's license… more
- BJC HealthCare (St. Louis, MO)
- …nurse experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization … 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
- Commonwealth Care Alliance (Boston, MA)
- …Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization Management ... to the Utilization Management Manager. * Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas,… more
- Commonwealth Care Alliance (Boston, MA)
- …service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
- Molina Healthcare (Milwaukee, WI)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... right place at the right time. + Functions as a hands-on supervisor , coordinating and monitoring clinical and non-clinical team activities to facilitate integrated,… more
- Dignity Health (Rancho Cordova, CA)
- …years Utilization experience required in health plan/UM operations, Acute or subacute utilization review . - Graduate of an accredited school of nursing. - BS ... Summary:** Under the guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is responsible and accountable for… more
- Children's Home Healthcare (Albuquerque, NM)
- …authorizations for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional ... Home Healthcare is now hiring for a RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in...on a 60 days basis per company policy. 9. Review /approve plan of care and all related documents prior… more
- Mitsubishi Chemical Group (Mesa, AZ)
- **Operations Planning Supervisor (2126)** + Title:Operations Planning Supervisor + Group Company: Mitsubishi Chemical Advanced Materials + Location:Mesa, AZ ... COMPANY. Job Purpose The purpose of the Operations Planning Supervisor is to ensure the efficient and timely production...and materials, to optimize production efficiency. + ERP System Utilization : Utilize the company's ERP system to input, track,… more
- City of Asheville (Asheville, NC)
- …applications are received. Education and Experience SKAs/Performance Aptitudes: + Data Utilization : Requires the ability to review , classify, categorize, ... Shop Supervisor Print (https://www.governmentjobs.com/careers/ashevillenc/jobs/newprint/5023862) Apply Shop Supervisor...- 6 pm + Hiring Rate: $66,293.38 + Initial review of applications will occur as received. This position… more
- BayCare Health System (Lakeland, FL)
- …bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + ... Rewarding Career with BayCare HomeCare as a Home Care Supervisor , RN. At BayCare, we are proud to be...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- Stanford University (Stanford, CA)
- Laboratory Services Supervisor (On-site) **School of Medicine, Stanford, California, United States** Research Post Date Jun 30, 2025 Requisition # 105806 The ... the School of Medicine is seeking a highly motivated Laboratory Services Supervisor to oversee its laboratory services, personnel, and operations involved in a… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor (2nd Shift) - Selinsgrove Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5002155) Apply Registered Nurse ... Supervisor (2nd Shift) - Selinsgrove Center Salary $96,225.00 -...services. You can expect to participate in the development, review , training and implementation of center policies and procedures.… more
- ChenMed (Winter Park, FL)
- …in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital at ChenMed. Special permission ... we need great people to join our team. The Supervisor , Intensive Community Care, RN is a multi-market leadership...patients achieve optimal health, access to care and appropriate utilization of resources. + Consults with, encourages and influences… more