- 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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
- 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
- AmeriHealth Caritas (LA)
- …Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity ... all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years...Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse +… 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
- Saint Francis Health System (OK)
- …is not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma ... levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate...participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shifts Covenant Health Overview: Covenant Health is the region's ... Forbes "Best Employer" seven times. Position Summary: The RN Utilization Management I will perform utilization...payors as applicable. + Completes daily work lists for utilization review meeting the time frames set… more
- University of Utah Health (Salt Lake City, UT)
- …+ Coordinate and communicate real-time staffing changes in conjunction with the Hospital Supervisor . + Review open shift requests and secure coverage as needed. ... care needs. + The role also involves proactive daily management to secure staff for open shifts to ensure...based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and… 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
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …years of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and understanding of ... Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the...with special projects as directed or requested by the supervisor or department director. Performs Concurrent Review … more
- California Energy Commission (Sacramento, CA)
- Data Management and Analytics Unit Supervisor PROGRAM AND PROJECT SUPERVISOR , PUBLIC UTILITIES COMMISSION $12,562.00 - $15,724.00 per Month New to State ... Position Details Job Code #: JC-501077 Position #(s): ###-962 Working Title: Data Management and Analytics Unit Supervisor Classification: PROGRAM AND PROJECT … more
- Mohawk Valley Health System (Utica, NY)
- Case Management Supervisor - Full Time - Days Department: CASE MGMT Job Summary The Case Management Supervisor is responsible for the oversight of the ... case management staff's authorization/coordination/ utilization and provision of member...direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring… 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
- Pacific Medical Centers (Renton, WA)
- …Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health ... and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted...USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly… more
- CareFirst (Baltimore, MD)
- …experience. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient ... **Resp & Qualifications** **PURPOSE:** The Inpatient Management Onsite Care Management Supervisor...This role will assist leadership with the development and review of Care Management standards, program criteria,… more
- WMCHealth (Valhalla, NY)
- …the procedures specified in the Clinical Care Management Department through review of the Utilization and Discharge Planning Program at Westchester Medical ... Supervisor Of Nursing - Clinical Care Management Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management … more
- WEG Electric Corp. (Duluth, GA)
- Accounts Payable Supervisor / Management Accountant **Department:** Finance **Location:** Duluth, GA About the role: ... (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req\_id=3477150&source=3477150-CJB-0) The Accounts Payable (AP) Supervisor - Management Accountant will primarily oversee a small… more
- L3Harris (Londonderry, NH)
- …land, sea and cyber domains in the interest of national security. Job Title: Supervisor , Operations Management Job Code: 31436 Job Location: Londonderry, NH Job ... Consult manufacturing engineers on any questions of proper handling. + Continually review and enforce the use and maintenance of work instructions, routers, logs,… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SUPERVISOR - 60005446 Date: Dec 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career Service Position Number: 60005446 Salary:… more
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