- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
- Alameda Health System (Oakland, CA)
- Clinical Nurse IV + Oakland, CA + Highland General...Services As Needed / Per Diem - Varies + Management + $76.03-$106.89 + Req #:42315-31381 + FTE:0.01 + ... of Administration during after hours, weekends, and holidays. Resource for the supervisor is the Administrator on-call; assumes a leadership role within the hospital… more
- Alameda Health System (Oakland, CA)
- Clinical Nurse V + Oakland, CA + Highland General Hospital...MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + FTE:1 + ... on each nursing unit for which responsible. Promotes effective and economic utilization of personnel and supplies. Monitors utilization of personnel and… more
- Commonwealth Care Alliance (Boston, MA)
- …Operations and in direct partnership with Care Delivery Business Ops and Clinical Management teams, the Supervisor partners in ensuring the delivery of primary ... Interdisciplinary Care Team members and/or other Clinical staff and management . In addition, the Supervisor is the...(nice to have): - Medical Assistant or Licensed Practical Nurse - Coding Certification Required Experience (must have): -… more
- Stony Brook University (Stony Brook, NY)
- …be performed on the donor. * The incumbent participates in and conducts blood utilization review with the direction of the Blood Bank Medical Director. The incumbent ... coordinates the staff who teaches the blood transfusion information portion of the nurse orientation program and recertification programs and acts as the nurse … more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I...SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization ...Supervisor Pay - $4.00 per hour + Charge Nurse Premium Pay - $1.50 per hour + Float ... Apply Senior Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually Location Ventura and Santa… more
- 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: ... and to support the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the… more
- Centene Corporation (Sacramento, CA)
- …Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- Actalent (Fort Lauderdale, FL)
- … Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... Prepare and present reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental Health + Clinical review… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… more
- Ascension Health (Murfreesboro, TN)
- …for resources and removal of barriers. + Maintain ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan. ... for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer date required. +… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SUPERVISOR - 60005446 Date: Oct 15, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career...Ability to analyze complex reports and determine the service utilization habits of clients and to evaluate the appropriateness… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor (2nd Shift) - Selinsgrove Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5095157) Apply Registered ... Nurse Supervisor (2nd Shift) - Selinsgrove Center...City Selinsgrove, Pennsylvania Zip Code 17870 Contact Name Talent Management Division Contact Email ###@pa.gov + Description + Benefits… more
- State of Minnesota (Annandale, MN)
- **Working Title: Registered Nurse Supervisor ** **Job Class: Registered Nurse Supervisor ** **Agency: Direct Care and Treatment** + **Job ID** : 89354 + ... Community Behavioral Health Hospital in Annandale is seeking a compassionate, person-centered Registered Nurse Supervisor to join our team! As the RN … 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
- Bon Secours Mercy Health (Richmond, VA)
- …hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Registered Nurse Supervisor (RN) - ASU PACU - FT - St. Mary's ... Hospital** Primary Function/General Purpose of Position The Surgery Supervisor is responsible for oversite of the staff and... is responsible for oversite of the staff and management of day-to-day operations of the unit in accordance… more
- Bon Secours Mercy Health (Greenville, SC)
- …an environment where associates want to work and help communities thrive. **Registered Nurse (RN) OR Supervisor Surgery** - **St. Francis Downtown - Greenville, ... SC** **Job Summary:** The Surgery Supervisor is responsible for oversite of the staff and management of day-to-day operations of the unit in accordance with… more
- HonorHealth (AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The RN Supervisor assists with essential department management functions to include ... but not limited to participation in business management activities, direct patient care, participation in process improvement...practice is guided by the ANA Standard for Professional Nurse and Code of Ethics. The RN has knowledge… more
