- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR ...for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform the ... I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 -… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… 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 ... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for treatment… more
- Centene Corporation (Jefferson City, MO)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... flexibility. **_ Remote Role _** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review team to… more
- Centene Corporation (Austin, TX)
- …WILL HAVE BCBA CERTIFICATION **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and ... of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
- AmeriHealth Caritas (Washington, DC)
- …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… 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)
- …and goals. Following the shift care workflow the case is presented to the Medical Director for medical necessity review . Upon approval of services, ... us at www.amerihealthcaritas.com. **Responsibilities:** Under the direction of the unit Supervisor , the Clinical Care Reviewer- Shift Care is responsible for… 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...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. + ... Employer. Position Summary: The RN Utilization Management I will perform utilization management functions to include medical necessity reviews to promote a… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has ... 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
- 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
- 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 ... service. This position is responsible for conducting retrospective claims review for services to determine the medical ...it related to the position.Bring to attention of the Supervisor , Utilization Management Care Coordinators, and 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. ... fax for inpatient and outpatient procedures, behavioral health, and durable medical equipment. Essential Accountabilities: Level I + Facilitates inbound and outbound… more
- Cedars-Sinai (Tarzana, CA)
- …of Oncology experience preferred. **Req ID** : 9636 **Working Title** : RN Oncology Supervisor - Ventana Oncology Medical - Tarzana **Department** : CSVOM - Med ... **Job Description** **Join Cedars-Sinai!** **Cedars-Sinai Medical Center has been ranked the #1 hospital...**What will you be doing in this role?** The Supervisor , Clinical Operations Oncology RN is responsible for supervising… 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
- Ellis Medicine (Schenectady, NY)
- …reports, functions and minutes. + Responsible for ensuring best practices of Utilization Review , Case Management, & Social Work Services following established ... The Continuum of Care Supervisor is responsible for supervising the Case Management...Coordinator is the key link between the HIM department, medical and nursing staff, compliance, clinical management, patient progression,… 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 for ... sets (Medicare Guidelines InterQual Health Plan Benefit Interpretation Guidelines and Medical Management Policies and DHMF Utilization Management guidelines and… 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
- AdventHealth (Minneola, FL)
- …services are provided to patients and pharmacy support services are available to medical and nursing staff to improve medication utilization and enhance ... services; outpatient laboratory; heart catheterization labs; critical care and general medical /surgical rooms. We are proud to be delivering clinical solutions for… more
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