- Sharp HealthCare (San Diego, CA)
- …clinical/medical necessity reviews and authorizes medical services that meet medical criteria. The review of care is region specific and consists of outpatient ... and employer business practices. **What You Will Do** The UM Resource Coord-SCMG serves as a resource to the...supervisor , team lead and/or medical director to discuss requests/ care inconsistent to criteria and determine the appropriateness of… more
- Sharp HealthCare (San Diego, CA)
- …appropriate Quality Management Department regarding any quality of service or quality of care issues encountered in the course of review . Collaborates with the ... **What You Will Do** To provide comprehensive utilization management and coordination of care for members who are confined to skilled nursing facilities (SNF) in… more
- LA Care Health Plan (Los Angeles, CA)
- …the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management ( UM ) Specialist by ... Supervisor , Authorization Technician Job Category: Clinical Department: Utilization...$75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- Dignity Health (Rancho Cordova, CA)
- …established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate ... one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works… more
- Pacific Medical Centers (Seattle, WA)
- **Description** The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management ( UM ) functions of US ... and implement strategic case management and utilization management yearly goals. The Supervisor Care Management RN demonstrates Pacific Medical Centers' core… more
- Centene Corporation (Raleigh, NC)
- …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 performance, compliance, quality, and efficiency standards +… more
- University of Michigan (Ann Arbor, MI)
- Pharmacy Technician Supervisor Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities through excellence in ... education, patient care , community service, research and technology development, and through...Match on retirement savings **Responsibilities As the Pharmacy Technician Supervisor , you will be responsible for performing activities relating… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... of Psychiatry has an exciting opportunity for a full-time Supervisor , Research Laboratory to work on the UHealth campus....its sub-studies, reporting to Dr. Deborah Jones at the UM Miller School of Medicine in Miami. In addition… more
- Immigration and Customs Enforcement (IN)
- …Management b. Resolution of complex and time sensitive utilization related issues c. Collection, review , tracking, and reporting of UM related data on a local, ... regarding Medical Payment Authorization Requests (MedPARs) for select reimbursable health care services, medical claims review , and utilization review… more
- Billings Clinic (Billings, MT)
- …Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings ... the next level of care , and expected discharge plan *Ensure that admission review is completed on assigned units/worklist using payer MCG or CMS 2 Midnight Rule… more
- University of Michigan (Ann Arbor, MI)
- …Time** Full-Time **Regular/Temporary** Regular **FLSA Status** Exempt **Organizational Group** Um Hospital **Department** MM Bmg Primary Care **Posting ... Allied Health Supervisor Senior Apply Now **How to Apply** A...Medical Group. A successful candidate will ensure high-quality patient care and guide in keeping with UMMG goals and… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking a Supervisor , Medical Technologists to work at the UM ... Miami. The incumbent will supervise laboratory personnel and schedules. The Supervisor , Medical Technologists will participate and assign weekly responsibilities to… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and service authorization ... review for medical necessity and decision-making. The Nurse Utilization...of service decisions and organizational determinations. The Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and… more
- LA Care Health Plan (Los Angeles, CA)
- …associated with LA Care 's ECM network. The position reports to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of ... practices to ECM providers. Conduct a monthly random sample review of Assessments and Care Plans created...with internal LA Care departments such as Care Management (CM), Utilization Management ( UM ), Managed… more
- InnovaCare (San Juan, PR)
- …Inpatient Coordinator.14. Prepares and submits to the Health Services Department / UM Medical Care Manager a monthly report of activities performed.15. ... the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization of… more
- Sharp HealthCare (Santee, CA)
- …to a patient being scheduled (ie Work comp visits have been authorized, PPO/MED Plan of Care has been completed and signed, UM has approved visits as needed). * ... the situation, and then presenting it to the PT Supervisor or supporting clinical specialist (PT II or PT...to the department policy.Promotes a positive atmosphere for patient care .Communicates with the patient in the treatment area explaining… more
- The Arora Group (Bethesda, MD)
- …all aspects and stages of the UM /RM program, identifying patient care process improvements, through continual review of processes. + Utilizes critical ... and take direction from the charge nurse and house supervisor as required in maintaining a safe environment for...stages of the UM /RM program, identifying patient care process improvements, through continual review of… more
- University of Michigan (Ann Arbor, MI)
- … UM Health Department of Pharmacy Services and to review our Annual report, please visit our website: https://www.medicine.umich.edu/dept/pharmacy **COMPETITIVE ... submission of the following: + Completed application via the UM Careers website + Letter of Intent or Cover...review , and maintain training materials, pharmacy standards of care , policies, and procedures with at least annual … more
- Providence (Everett, WA)
- …Medical Group as downstream providers. Performs other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines. ... performance related utilization management data. Process of daily, weekly and monthly UM reports. Establishes and maintains efficient filing system in paper and… more
- Baystate Health (Springfield, MA)
- …level of care to promote optimal health. Serve as a clinical liaison between the primary care team and HNE UM staff. Under the direction of an RN, the LPN ... UM collaborates with the patient, patient's entire primary care team, and the Health New England UM...to provide to HNE to support the medical necessity review process and plan of care . +… more