- CoxHealth (Springfield, MO)
- …CoxHealth Job Summary An RN who is responsible for clinical patient care management , human and financial asset utilization , and operational management of ... Required: Bachelor’s Degree in Nursing Experience Preferred: At least five years of clinical experience, one year of charge nurse experience, and one year experience… more
- Merck & Co. (Rahway, NJ)
- …management to drive overall success and performance of the area and clinical pipeline.-Accountability First line operations supervisor with a team of ... biologics, vaccine) Drug Product development and Good Manufacturing Practice (GMP) clinical manufacturing plant in Rahway, New Jersey. The Sterile Production … more
- Tenethealth (Bryan, TX)
- …in the planning, development and implementation, and ongoing success of the Clinical Documentation Management Program within the company. Educates members of ... records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness,… more
- Tenethealth (Frisco, TX)
- …in the planning, development and implementation, and ongoing success of the Clinical Documentation Management Program. Educates members of the patient care ... JOB SUMMARY Manages activities of the Clinical Documentation Improvement department locally and/or across other...and resolving problems. No. Direct Reports (incl. titles) CDI Supervisor and CDI Lead No. Indirect Reports (incl. titles)… more
- jobvibe (Conway, NH)
- …from the RN as necessary; At the direction of the RN, participates in Utilization Management or Interdisciplinary Care Management Meeting to facilitate ... EXPOSURE: Category I DEPARTMENT: Nursing REPORTS TO: RN Nursing Supervisor /Unit Manager/Center Nurse Executive GRADE: 15 FLSA: Nonexempt POSITION SUMMARY:… more
- Monster (Atlanta, GA)
- …co-lead for most programming, will also be expected to provide direct clinical case consultation to department command staff regarding mental health related concerns ... and officers. Conduct annual to bi-annual wellness checks through the utilization of mental health screening measure and brief psychoeducational interview. Conduct… more
- Monster (Louisville, KY)
- …Development Program VOA University - Staff Development VOA Academy - Clinical Training and Development JOB SUMMARY AND QUALIFICATIONS: Service Coordinator will ... be responsible for ensuring maximum utilization of community resources by residents of Volunteers of...contact with resident or family members; document all case management activities. 3. Identify community resources and develop cooperative… more
- AmeriHealth Caritas (Washington, DC)
- …ON BONUS** **Role Overview:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Centene Corporation (Columbus, OH)
- … 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
- Centene Corporation (Madison, WI)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services...performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH… more
- Insight Global (Downers Grove, IL)
- …in Nursing Current RN, LPN or LVN licensure 3 years of recent clinical experience, specifically within Utilization Management Recent Supervisory Experience ... Job Description Insight Global is seeking a Quality Assurance Supervisor to join or client's team. The ideal candidate...candidate will be responsible for the audit of nationwide utilization management teams. this candidate will work… more
- Ventura County (Ventura, CA)
- …as needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management activities based ... Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply ...+ Preceptor Pay - $2.50 per hour + House Supervisor Pay - $4.00 per hour + Charge Nurse… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in department) - Provides guidance and leadership to the daily activities of the Utilization Management Department clinical staff. Acts as resource to ... staff, members and providers. + Provides backup for the Supervisor , whenever necessary. Participates in the orientation of new...Bachelors degree preferred. + Minimum of three years of clinical experience required. Utilization Management … more
- Catholic Health Services (Melville, NY)
- …Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of ... and payment related activities. Position Responsibilities: Prepares necessary documentation for utilization management and appeals processes, performs data … more
- Helio Health Inc. (Syracuse, NY)
- …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the supervision of the Utilization Management (UM) Operations Supervisor , the UM Coordinator I's primary job function is to support UM ... operations by performing any non- clinical tasks. This includes, but is not limited to, initial authorization processing, (data entry, eligibility verification,… more
- Mount Sinai Health System (New York, NY)
- …on Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Samaritas (Grand Rapids, MI)
- Position Details CLINICAL SUPERVISOR - GRAND RAPIDS AREA - MENTAL / BEHAVIORAL HEALTH Do you have a Master's Degree and are you a licensed clinician with a ... - Pre-Pay Options + Plus, many more benefits The Clinical Supervisor is accountable to the Director...training as needed + Responsible for tracking and monitoring utilization and outcome data, including quarterly reporting for the… more
- Children's Home Healthcare (Albuquerque, NM)
- …A VALID RN LICENSE* Children's Home Healthcare is now hiring for a RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in Pediatric Home ... this growing professional team! We are seeking an experienced Clinical Supervisor in the Albuquerque area. The...skills and willing to travel to patient homes + Utilization Management Experience + Reliable transportation for… more
- Boston University (Boston, MA)
- **FLOATING CLINICAL CARE SUPERVISOR , School of Dental Medicine, Clinical Affairs** **Job Description** **FLOATING CLINICAL CARE SUPERVISOR , School of ... Date** 8/21/2025 **Salary Grade** Grade 47 **Position Type** Full-Time/Regular The Floating Clinical Care Supervisor is responsible to manage, provide guidance… more
