- Centene Corporation (Raleigh, NC)
- … 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
- 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 ... (Medicare Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management guidelines… more
- Corewell Health (Caledonia, MI)
- …everyone. Together, we are Corewell Health. Scope of Work Supervises assigned Utilization Management staff. Plans, organizes, and supervises all assigned ... Evaluates staff competencies and identifies training needs. Experience with Utilization Review of Inpatient or Inpatient appeal...- 4700 60th St - Grand Rapids Department Name Utilization Management - GR Employment Type Full… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE ... loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This...concerns they have in this regard with their immediate supervisor and/or the Vice President People Resources. All employees… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...Review or + Required 2 years in Case Management + Preferred 3 years Registered Nurse in Critical… more
- Amity Foundation (Tucson, AZ)
- …individuals with a desire to teach, learn and join our community as a Utilization Review Specialist at our campus in Tucson, AZ. With this groundbreaking ... community building Remembrance, Resolution, Reconciliation, Restoration, Renewal About the Position Utilization Review Specialist you will contribute to the… more
- Universal Health Services (Bradenton, FL)
- …alternate treatment sources when appropriate. The Director of Admissions/ Utilization Management performs admission and concurrent review of patients. Assures ... Health is currently seeking a Director of Admissions and Utilization Management Palm Shores Behavioral Health Center...Health field + Two (2) years experience as a supervisor or in a leadership capacity + Stable emotional… more
- Sharp HealthCare (San Diego, CA)
- …time for routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to the appropriate persons ... + Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as… more
- Sharp HealthCare (San Diego, CA)
- …+ Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as ... necessity reviews and authorizes medical services that meet medical criteria. The review of care is region specific and consists of outpatient healthcare services… more
- CVS Health (Columbus, OH)
- …is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the ... wellness. Services strategies, policies and programs are comprised of network management and clinical coverage policies.What is A1A?Aetna One Advocate is Aetna's… more
- CVS Health (Raleigh, NC)
- …is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the ... wellness. Services strategies, policies and programs are comprised of network management and clinical coverage policies.What is A1A?Aetna One Advocate is Aetna's… more
- Kepro (IN)
- …team. Job Summary: The Clinical Supervisor - RN is responsible for the management and oversight of the: + Indiana Utilization Management activities. + ... meet contract requirements. + Day-to-day oversight to manage the Utilization Review (UR) program and clinical staff...experience in a Lead position in a Quality and Utilization Management program, including the two (2)… more
- Universal Health Services (Shippensburg, PA)
- Responsibilities Clininical Supervisor - Social Work/ Utilization Management Roxbury is currently hiring a Clinical Supervisor to oversee the clinical ... directly to the Director of Clinical Services. The Clinical Supervisor , Social Work/ Utilization Review , provides...If you would like to learn more about the Supervisor , Social Work/ Utilization Management position… more
- Pacific Medical Centers (Seattle, WA)
- …USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. The Supervisor Care Management ... **Description** The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM)… more
- CareFirst (Baltimore, MD)
- …Licensure. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient ... **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates...years Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or… more
- Centene Corporation (Tallahassee, FL)
- … policies, procedures and processes. + Facilitate on-going communication between case management staff, utilization management staff and contracted ... a medical/surgical, pediatrics, or obstetrics environment. 1+ year of case and/or utilization management experience. Working knowledge of a specialized or… more
- AdventHealth (Altamonte Springs, FL)
- …with visionary leadership and world-class resources **The role you'll contribute:** **The Care Management Supervisor is under the general leadership of the Care ... and performing the daily operations and supervision of team members in the Care Management department.** **The Care Management Supervisor is responsible for… more
- Bassett Healthcare (Oneonta, NY)
- …to staff regarding "new" therapeutic modalities and medications (measured by peer review and management .) Assists Clinical Coordinators in training of new ... and continuing Education of current employees (measure by peer review and management observation) Act as a...techniques measured by documentation of inservice log sheet, peer review and supervisor observation. Reports promptly, any… more
- Dairy Farmers of America (Toledo, OH)
- …efficient manner. The Mix Room Supervisor will coordinate mix room activities and mix utilization on a daily basis. The Mix Room Supervisor will serve as a ... **Position** : Mix Room Supervisor **Location** : Toledo, Ohio **Requisition ID:** :...management and other supervisory staff to assign, direct, review and monitor work of supervised staff to maximize… more
- Aston Carter (Fitchburg, WI)
- …and maximizes the utilization of billable resources. They work with services management to ensure the technical development for an assigned team. Key Areas of ... accurate invoicing of clients through time and expense approval Review and collaborate with services management on...and project bookings Work with peers to maximize total utilization company wide Skills: Project management , Project… more