- 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 NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...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 NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… 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
- 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
- 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
- St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
- …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... , supporting the agency's mission and client care quality. Department Utilization Review Employment Type Full-Time Minimum Experience Mid-level Compensation… 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 ... Working under the general supervision of the Director and/or Manager/ Supervisor of Medical Management, and in collaboration with an...present reports on department activities. Essential Skills + Clinical review + Utilization review +… 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 Full Time, 80 Hours Per Pay...to non-clinical precertification staff. + Assists with delayed claims review to determine appropriate number of observation hours as… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Commonwealth Care Alliance (Boston, MA)
- …service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Sharp HealthCare (San Diego, CA)
- …Do** The UM Care Coordinator, under the direct supervision of the Supervisor , Utilization Management Care Coordinators, prepares referral requests for outpatient ... care, managed care, as it related to the position.Bring to attention of the Supervisor , Utilization Management Care Coordinators, and UM Manager, areas of UM… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. ... + Assist with all Blue Card Claims escalations. + Assist management with the review and creation of desk level procedures, acting as a subject matter expert for… more
- CN (Geismar, LA)
- …because the work we do matters. Join us! **Job Summary** The Transportation Supervisor is an entry-level front line supervisor position responsible for meeting ... and in compliance with governing regulations and CN's operating rules. The Transportation Supervisor may also be an on-call position that reports to remote locations… more
- HCA Healthcare (Asheville, NC)
- …satisfaction and personal growth, we encourage you to apply for our Supervisor Pharmacy Medication Reconciliation opening. We promptly review all applications. ... integrity. We care like family! Jump-start your career as a(an) Supervisor Pharmacy Medication Reconciliation today with Mission Hospital. Benefits Mission Hospital,… more
- Children's Home Healthcare (Albuquerque, NM)
- …authorizations for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional ... Home Healthcare is now hiring for a RN Clinical Supervisor /Case Manager! Children's HH is the premier leader in...on a 60 days basis per company policy. 9. Review /approve plan of care and all related documents prior… more
- Providence (Everett, WA)
- **Description** The Supervisor for Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management ... upon hire + Previous healthcare administration and/or delivery of healthcare services + Utilization Management/ Review . + Experience related to a wide variety of… more
- Tidelands Health (Murrells Inlet, SC)
- …coding, billing and collections and other budget related duties as assigned. The supervisor is responsible for ongoing review , assessment and education of ... Tidelands and help people live better lives through better health!** **Nurse Supervisor (RN)** Are you passionate about quality and committed to excellence? Consider… more
- AdventHealth (Minneola, FL)
- …spirit in the Minneola community._ **The role you'll contribute:** _The Pharmacy Supervisor is responsible for ensuring an efficient and effective workflow in all ... levels, and providing administrative support and supervision of pharmacy staff. The supervisor may work in centralized or decentralized areas and is accountable for… more