- 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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
- AmeriHealth Caritas (Philadelphia, PA)
- …us at www.amerihealthcaritas.com. **Responsibilities:** Under the direction of the unit Supervisor , the Clinical Care Reviewer- Shift Care is responsible for ... the case is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification and education to… more
- Actalent (Sunrise, FL)
- …cases, internal process development, and educates physicians and team members on utilization review issues. Ensuring smooth transitions and patient satisfaction ... Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a...present reports on department activities. Essential Skills + Clinical review + Utilization review +… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Centene Corporation (Jefferson City, MO)
- …flexibility. **_ Remote Role _** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical 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… more
- Centene Corporation (Austin, TX)
- …WILL HAVE BCBA CERTIFICATION **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
- Sedgwick Government Solutions (Charleston, SC)
- Job Details Utilization Review Case Manager RN (Remote) 2025-1434 Charleston, SC, USA Medical Services Full Time Description ** Utilization Review Case ... and support through our highly skilled team of home-based Utilization Review Case Managers. Are you looking...appropriate department. + Meets productivity goals as outlined by supervisor . + Maintains privacy, as per Program guidelines, within… more
- Louisiana Department of State Civil Service (Reserve, LA)
- REGISTERED NURSE SUPERVISOR B Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947288) Apply REGISTERED NURSE SUPERVISOR B Salary ... as, Nursing Policy and Procedure Committee, patient safety, quality assurance, and utilization review . Supervises the ordering of medical supplies and materials… more
- Louisiana Department of State Civil Service (Reserve, LA)
- REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947231) Apply REGISTERED NURSE SUPERVISOR A Salary ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
- State of Colorado (Denver, CO)
- Nursing Supervisor - Nurse III - Colorado Mental Health Hospital in Fort Logan (S. Denver) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4961360) Apply Nursing Supervisor - Nurse III - Colorado Mental Health Hospital in Fort Logan… more
- Covenant Health Inc. (Knoxville, TN)
- …meetings between physicians and payors as applicable. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Overview Registered Nurse , Revenue Integrity & Utilization Management...to non-clinical precertification staff. + Assists with delayed claims review to determine appropriate number of observation hours as… more
- New York State Civil Service (Batavia, NY)
- …Mental Health Nurse , (including all parenthetic), Infection Control Nurse , or Senior Utilization Review Nurse ;Or 2. One year in any Grade 16 or ... NY HELP Yes Agency Health, Department of Title Registered Nurse Supervisor 1 (Veterans Home at Batavia) (NY HELPS) - 40205 Occupational Category Health Care,… more
- New York State Civil Service (Montrose, NY)
- …Mental Health Nurse , (including all parenthetic), Infection Control Nurse , or Senior Utilization Review Nurse ;Or 2. One year in any Grade 16 or ... NY HELP Yes Agency Health, Department of Title Registered Nurse Supervisor 1 (NY HELPS) (Veterans Home at Montrose) - 90208 Occupational Category Health Care,… more
- Trinity Health (Muskegon, MI)
- **Employment Type:** Full time **Shift:** Night Shift **Description:** FT Nights Clinical Nurse Supervisor Obstetrics, Women and Newborns Services The Clinical ... departments to ensure timely and efficient service delivery. **What the Clinical Supervisor will do:** + Develops master plans (with manager/staff input) for areas… more
- Corewell Health (Grand Rapids, MI)
- …able to provide care for long term care residents and post-acute rehab patients. Nurse -patient ratios vary depending on the shift and the population you will be ... of interdisciplinary collaborative relationships. Will provide oversight to the registered nurse and licensed practical nurse clinical practices. Will… more
- Community Health Systems (Antioch, TN)
- As a Supervisor of the Transfer Center at Access Center Services you'll join a team and be a part of a culture that's dedicated to providing top quality care to our ... reimbursement, and student loan assistance for eligible roles **Job Summary** The Supervisor , Transfer Center is responsible for leading daily activities of the… more
- Bassett Healthcare (Cooperstown, NY)
- …specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Inpatient Psychiatry unit is accountable for ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- The Arora Group (Bethesda, MD)
- …+ Report to the Nurse Manager, and take direction from the charge nurse and house supervisor as required in maintaining a safe environment for staff ... Registered Nurse Case Manager Nurse Currently recruiting...cost diagnoses. + Independently perform difficult and complex assessment, review , coordination, planning, monitoring, evaluation and analysis of cases.… more