• Keurig Dr Pepper (Tucson, AZ)
    Job Overview: Maintenance Supervisor - Tucson, AZThe Maintenance Supervisor is responsible for coordinating, planning, and overseeing the Maintenance department, ... process improvements to enhance changeover and line efficiencyOptimize asset utilization and plant performanceProvide training to upskill maintenance techniciansSchedule… more
    JobGet (04/30/25)
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  • Supervisor , Utilization

    LA Care Health Plan (Los Angeles, CA)
    Supervisor , Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day… more
    LA Care Health Plan (04/11/25)
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  • Clinical Supervisor , Utilization

    VNS Health (Manhattan, NY)
    …Will Do + Supervises the day-to-day operations of VNS Health Plans Medical Management clinical and non clinical staff. Makes recommendations to the development, ... utilization , and evaluation of internal processes to ensure customer...in addressing and resolving day-to-day operational issues. + Assists management team in the development of long- and short-… more
    VNS Health (04/02/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Phoenix, AZ)
    …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... adherence to performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH care member issues related to BH… more
    Centene Corporation (04/09/25)
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  • Utilization Management

    UCLA Health (Los Angeles, CA)
    …Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff ... schedules to efficiently handle incoming referrals and phone call volume. You will develop workflows, desktop procedures, forms, training materials, and protocols for achieving team objectives and key performance indicators. You will hire and train… more
    UCLA Health (03/04/25)
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  • RN Supervisor UM Prior Auth

    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
    Dignity Health (04/17/25)
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  • Supervisor Quality RN

    Providence (Everett, WA)
    **Description** The Supervisor for Utilization Management provides a key role in leading, facilitating and managing the hospital utilization ... upon hire + Previous healthcare administration and/or delivery of healthcare services + Utilization Management /Review. + Experience related to a wide variety of… more
    Providence (04/23/25)
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  • Behavioral Health Utilization

    AmeriHealth Caritas (Charleston, SC)
    …about us at www.amerihealthcaritas.com . **Responsibilities:** Under the direction of the Supervisor , the Behavioral Health Utilization Management Reviewer ... years of behavioral health and substance use disorder experience.; + Utilization management experience in a managed care organization preferred. + Proficiency in… more
    AmeriHealth Caritas (03/18/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Dover, DE)
    …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... efficiency metrics in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon to: + Conduct concurrent reviews… more
    AmeriHealth Caritas (04/29/25)
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  • Physician Advisor

    WellSpan Health (York, PA)
    …peer cases for need of retrospective external appeal-and funnel those cases to the Supervisor of Utilization Management for expedition. + Reviews cases ... Management staff. Duties and Responsibilities Essential Functions: + Renders utilization management determination in accordance with State and Federal… more
    WellSpan Health (04/10/25)
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  • Supervisor - UM Administration Clinical…

    Humana (Columbus, OH)
    …health first** The Supervisor , UM Administration contributes to administration of utilization management . The Supervisor , UM Administration works within ... analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and… more
    Humana (04/25/25)
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  • Utilization Review (UR) Supervisor

    Spectrum Billing Solutions (Skokie, IL)
    …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR Supervisor ... and clinical 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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  • Utilization Management Reviewer, RN

    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
    Excellus BlueCross BlueShield (03/29/25)
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  • Manager, Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine...on a rotating basis with other managers when on-call Supervisor is unavailable. + Develops and oversees relationships and… more
    Stanford Health Care (02/22/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of ... payment related activities. Position Responsibilities: | Prepares necessary documentation for utilization management and appeals processes, performs data … more
    Catholic Health Services (02/14/25)
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  • Utilization Management Services Rep…

    Excellus BlueCross BlueShield (Rochester, NY)
    …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... attendance is expected and required. + Performs other functions as assigned by management . Level II (in addition to Level I Accountabilities) + Assists and performs… more
    Excellus BlueCross BlueShield (04/27/25)
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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 ... Assistant Certification (CMA) upon hire. + 1 year of experience in utilization management or case management with experience in medical terminology and… more
    Providence (03/07/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
    Helio Health Inc. (04/02/25)
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  • Utilization Review Specialist

    Amity Foundation (Tucson, AZ)
    …individual is responsible for performing a variety of concurrent and retrospective utilization management -related reviews and functions and for ensuring that ... building. Remembrance, Resolution, Reconciliation, Restoration, Renewal Job Summary: As the Utilization Review Specialist, you will contribute to the organization by… more
    Amity Foundation (03/08/25)
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  • Full-time Utilization Review Specialist

    St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
    …Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: $22.00/hour ... and coordinate account card reimbursements, if necessary. + Support behavioral utilization activities, aligning with agency policies to promote optimal client care… more
    St Joseph's Addiction Treatment & Recovery Centers (04/15/25)
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