• UM Resource Coord LVN - Utilization Mgmt…

    Sharp HealthCare (San Diego, CA)
    …requirements for the position, and employer business practices. **What You Will Do** The UM Resource Coord-SCMG serves as a resource to the various teams in the SCMG ... UM Department. Prepares referral requests for outpatient services, elective...and authorizes medical services that meet medical criteria. The review of care is region specific and consists of… more
    Sharp HealthCare (06/01/24)
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  • UM Specialist (LVN) - SNF - Sharp Extended…

    Sharp HealthCare (San Diego, CA)
    …Sharp Extended Care (SEC) provider on site and/or telephonically. Keeps SEC Nurse Supervisor or SEC provider of any adverse development, delay in discharge or ... Informs quality department of any quality issues. + Chart review Performs a comprehensive review of medical...issues. + Chart review Performs a comprehensive review of medical history, doctor's orders, progress notes, therapy… more
    Sharp HealthCare (04/03/24)
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  • Supervisor , Authorization Technician

    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...Technicians Leads, Authorization Technician and clerical staff in the UM department. Ensure Associate Supervisors are providing consistent and… more
    LA Care Health Plan (05/09/24)
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  • RN Supervisor Utilization Management

    Dignity Health (Rancho Cordova, CA)
    …Under the guidance and supervision of the department Manager/Director, the Supervisor of Utilization Management is responsible and accountable for coordination of ... supervision this position is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to ensure requests are processed in a… more
    Dignity Health (05/12/24)
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  • Delegation Oversight Clinical Auditor RN II

    LA Care Health Plan (Los Angeles, CA)
    …RN II is responsible for ensuring that delegates contracted to perform Utilization Management ( UM ) functions on behalf of LA Care (LAC) is in compliance with all ... UM regulatory requirements and new legislation through the maintenance...through these processes. Prepares the Delegation Oversight Department for review by external regulatory bodies. Ensures that the Delegation… more
    LA Care Health Plan (05/16/24)
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  • Clinical Microbiology Laboratory Supervisor

    University of Michigan (Ann Arbor, MI)
    Clinical Microbiology Laboratory Supervisor Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the ... to this position. **Summary** The Department of Pathology is seeking a Supervisor (Allied Health Intermediate Supervisor ) for the Clinical Microbiology… more
    University of Michigan (05/17/24)
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  • Evening/Midnight Pharmacy Technician…

    University of Michigan (Ann Arbor, MI)
    Evening/Midnight Pharmacy Technician Supervisor Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities ... + 2:1 Match on retirement savings **Responsibilities As the Pharmacy Technician Supervisor , you will be responsible for performing activities relating to and… more
    University of Michigan (06/01/24)
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  • Utilization Review RN

    Billings Clinic (Billings, MT)
    …here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic Main ... loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This position is to conduct initial, concurrent,… more
    Billings Clinic (03/13/24)
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  • Supervisor , Medical Technologists

    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
    University of Miami (04/17/24)
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  • Utilization Management Physician Lead

    Intermountain Health (Las Vegas, NV)
    **Job Description:** This position interacts with UM physician and operational leadership. As the UM Physician Reviewer, you are responsible, in partnership with ... the Sr. Director of UM and the Director of Claims, to conduct peer-to-peer...Leadership. Job Profile: + Trains and educates on medical review activities pertaining to utilization review , claims… more
    Intermountain Health (05/24/24)
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  • Supervisor Intake Coordination

    Highmark Health (Columbus, OH)
    …This job supervises and coordinates the day to day activities of the UM Intake Coordination team. The incumbent selects, develops and continuously coaches staff to ... department in compliance audits as it relates to the supervisor functions. + Act as subject matter expert for...with providers via phone.At times, build cases in Utilization Review system during high volume times. + Other duties… more
    Highmark Health (05/21/24)
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  • Office Manager (Marine campus, Facilities…

    University of Miami (Miami, FL)
    …events on ad hoc basis as assigned. + Initiates reports/correspondence, internally & outside UM on behalf of supervisor . + Performs other duties as assigned. The ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Facilities Department… more
    University of Miami (05/31/24)
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  • Concurrent Review Nurse-( Auditor)- Metro,…

    InnovaCare (San Juan, PR)
    …the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization of ... visits to Acute, SNF, and Rehabilitation Inpatient facilities to concurrently review admissions and continued stay to determine appropriate Utilization, Quality… more
    InnovaCare (04/17/24)
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  • PT Specialist II - Neuro/Ortho - Full-time SD…

    Sharp HealthCare (Santee, CA)
    …then resolving it or presenting it with a possible solution to the PT Supervisor or supporting clinical lead or specialist for resolution in a timely manner.Consults ... outcomes.Courtesy and customer service will be measured by clinical lead or Supervisor observation, physician and peer feedback, SharpStar nominations and written or… more
    Sharp HealthCare (05/16/24)
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  • PT Spec I - Orthopedic/Neurological- Day Shift/Per…

    Sharp HealthCare (Santee, CA)
    …the problem, apologizing, tracking the situation, and then presenting it to the PT Supervisor or supporting clinical specialist (PT II or PT III) for resolution in a ... and customer service will be measured by PT Spec III or Supervisor observation, physician and peer feedback, SharpStar nominations and written or verbal… more
    Sharp HealthCare (05/05/24)
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  • Registered Nurse Case Manager

    The Arora Group (Bethesda, MD)
    …high cost diagnoses. + Independently perform difficult and complex assessment, review , coordination, planning, monitoring, evaluation and analysis of cases. + Screen ... to the Nurse Manager, and take direction from the charge nurse and house supervisor as required in maintaining a safe environment for staff and patient(s). +… more
    The Arora Group (04/16/24)
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  • Pharmacy Technician Trainer CVC/OR

    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 ... successful completion and submission of the following: + Completed application via the UM Careers website + Letter of Intent or Cover Letter + Updated curriculum… more
    University of Michigan (05/03/24)
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  • Office Manager

    University of Miami (Coral Gables, FL)
    …Accounting Adjustments (PAA) in workday. + Initiates reports/correspondence, internally & outside UM on behalf of supervisor . + Ensures compliance with ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Under the supervision… more
    University of Miami (05/17/24)
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  • Utilization Management Assistant

    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
    Providence (05/10/24)
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  • Licensed Practical Nurse

    Baystate Health (Springfield, MA)
    …(LPN) functions under the supervision and guidance of the Nursing Supervisor , Physician, or Advance Practitioner and participates in the multi-disciplinary process ... clinical liaison between the primary care team and HNE UM staff. Under the direction of an RN, the...to provide to HNE to support the medical necessity review process and plan of care. + Support a… more
    Baystate Health (04/12/24)
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