• Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
    The County of Los Angeles (03/30/25)
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  • Utilization Review (UR)…

    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 ... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for treatment… more
    Spectrum Billing Solutions (04/01/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Phoenix, AZ)
    …for this remote position.** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and ... of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
    Centene Corporation (04/09/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Dover, DE)
    …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
    AmeriHealth Caritas (04/29/25)
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  • Utilization Review Specialist

    Amity Foundation (Tucson, AZ)
    …building. Remembrance, Resolution, Reconciliation, Restoration, Renewal Job Summary: As the Utilization Review Specialist, you will contribute to the ... under pressure generated by association with substance abuse students. Title: Utilization Review Specialist Reports To: Dragonfly Program Director Job… more
    Amity Foundation (03/08/25)
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  • Full-time Utilization Review

    St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
    …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... , supporting the agency's mission and client care quality. Department Utilization Review Employment Type Full-Time Minimum Experience Mid-level Compensation… more
    St Joseph's Addiction Treatment & Recovery Centers (04/15/25)
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  • Utilization Management Reviewer, RN

    Excellus BlueCross BlueShield (Rochester, NY)
    …with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or otherwise ... position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and...regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and… more
    Excellus BlueCross BlueShield (03/29/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    …timely follow through. | Reviews providers' requests for services and coordinates utilization /appeals management review . | Assist Utilization and Appeals ... was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate … more
    Catholic Health Services (02/14/25)
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  • Utilization Case Manager

    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
    Helio Health Inc. (04/02/25)
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  • Manager, Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …- 5+ years of experience as an RN - 3+ years of experience in case management/ utilization review Why work at Stanford Medicine | Stanford Health Care (SHC)? - ... Recognized as a top Academic Medical Center globally! - Ranked No. 10 on the...Knowledge of principles and best practices of case management, utilization review , social work, care coordination and… more
    Stanford Health Care (02/22/25)
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  • Utilization Management Assistant

    Providence (Anaheim, CA)
    **Description** Under the direction of the Utilization Supervisor / Manager, this position is responsible for the distribution, review , accurate and timely ... in utilization management or case management with experience in medical terminology and coding. **Why Join Providence?** Our best-in-class benefits are uniquely… more
    Providence (03/07/25)
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  • Behavioral Health Utilization Management…

    AmeriHealth Caritas (Charleston, SC)
    …Under the direction of the Supervisor , the Behavioral Health Utilization Management Reviewer is responsible for completing medical necessity reviews. ... to collect all information necessary to perform a thorough medical necessity review . It is within the...of behavioral health and substance use disorder experience.; + Utilization management experience in a managed care organization preferred.… more
    AmeriHealth Caritas (03/18/25)
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  • Utilization Management Services Rep…

    Excellus BlueCross BlueShield (Rochester, NY)
    …you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. ... fax for inpatient and outpatient procedures, behavioral health, and durable medical equipment. Essential Accountabilities: Level I + Facilitates inbound and outbound… more
    Excellus BlueCross BlueShield (04/27/25)
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  • Supervisor Medical Management…

    McLaren Health Care (Flint, MI)
    …Plan role will be supporting. + Two (2) years' experience in a managed care/HMO utilization review and/or case management role. + Available to work a flexible ... We are looking for a Supervisor , Medical Management Registered Nurse, to...decision making. The primary focus for daily responsibilities includes utilization and case management process review and… more
    McLaren Health Care (04/11/25)
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  • RN Oncology Supervisor - Ventana Oncology…

    Cedars-Sinai (Tarzana, CA)
    …throughout Los Angeles and beyond. **Req ID** : 7336 **Working Title** : RN Oncology Supervisor - Ventana Oncology Medical - Tarzana **Department** : CSVOM - Med ... **Job Description** **Join Cedars-Sinai!** **Cedars-Sinai Medical Center has been ranked the #1 hospital...**What will you be doing in this role?** The Supervisor , Clinical Operations Oncology RN is responsible for supervising… more
    Cedars-Sinai (04/16/25)
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  • Supervisor Pharmacy Medication…

    HCA Healthcare (Asheville, NC)
    …satisfaction and personal growth, we encourage you to apply for our Supervisor Pharmacy Medication Reconciliation opening. We promptly review all applications. ... integrity. We care like family! Jump-start your career as a(an) Supervisor Pharmacy Medication Reconciliation today with Mission Hospital. Benefits Mission Hospital,… more
    HCA Healthcare (02/08/25)
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  • Supervisor , Medical Coding

    University of Utah (Salt Lake City, UT)
    …**Job Title** Supervisor , Outpatient / Provider Coding **Working Title** Supervisor , Medical Coding **Job Grade** F **FLSA Code** Nonexempt **Patient ... of U Health - Academics **Department** 00209 - Univ Medical Billing - Oper **Location** Other **City** Other **Type...Posting **Pay Rate Range** 76000-81000 **Close Date** 07/25/2025 **Priority Review Date (Note - Posting may close at any… more
    University of Utah (04/28/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Jackson, LA)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4915645) Apply  REGISTERED NURSE...for this vacancy as well as future job opportunities. REVIEW YOUR APPLICATION TO MAKE SURE IT IS CURRENT.… more
    Louisiana Department of State Civil Service (04/24/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Reserve, LA)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4922284) Apply  REGISTERED NURSE SUPERVISOR A Salary… more
    Louisiana Department of State Civil Service (04/29/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Pineville, LA)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient ... Registered Nurse Supervisor A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4919172) Apply  Registered Nurse Supervisor A Salary… more
    Louisiana Department of State Civil Service (04/26/25)
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