- University of Rochester (Rochester, NY)
- …as defined by NYS Laws and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and management responsibilities ... in medication dispensing. **ESSENTIAL FUNCTIONS** **_Clinical Staff Pharmacist - Medication Authorization and Distribution_** + Directs and supervises the work of… more
- Cuyahoga County Board of Developmental Disabilities (Cleveland, OH)
- …to ensure fiscal responsibility including:use of Cost Projection Tools, the Prior Authorization Review Process, implementation of AAI Administrative Review, ... and utilization of Medicaid State Plan Services. Deliver technical assistance...to Support Administrators, Providers, and Waiver Coordinators regarding these authorization processes. + Assist Managers to hire, train, and… more
- WEC Energy Group (West Allis, WI)
- Operations Supervisor We Energies, a subsidiary of WEC Energy Group, is seeking a Operations Supervisor in our West Allis, WI location. About Us WEC Energy Group ... to change lives, this is the place for you. Job Summary The Operations Supervisor may be rotated to other work areas/functions within Customer Operations in order to… more
- Mohawk Valley Health System (Utica, NY)
- … is responsible for the oversight of the case management staff's authorization /coordination/ utilization and provision of member services. Duties include the ... Case Management Supervisor - Full Time - Days Department: CASE...direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member… more
- Mohawk Valley Health System (Utica, NY)
- …SNH is responsible for the oversight of the case management staff's authorization /coordination/ utilization and provision of member services. Duties include the ... RN Supervisor Case Management - Full Time - Days...direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member… more
- Air National Guard Units (Peoria, IL)
- …EXCEPTED SERVICE POSITION. This National Guard position is for a AIRCRAFT MAINTENANCE SUPERVISOR (Title 32), Position Description Number D1444000 and is part of the ... IL 182 AW, National Guard. Responsibilities As an AIRCRAFT MAINTENANCE SUPERVISOR (Title 32), WS-8801-14, you will Major Duties - This is NOT an all-inclusive list:… more
- Air National Guard Units (Milwaukee, WI)
- Summary This National Guard position is for a AIRCRAFT MECHANIC SUPERVISOR - Title 32, Position Description Number D0806000 and is part of the WI 128 MXS, Wisconsin ... Air National Guard. Responsibilities As a AIRCRAFT MECHANIC SUPERVISOR - Title 32, WS-8852-12, you will provide overall direction and coordination of the subordinate… more
- Stark County Board of Developmental Disabilities (Canton, OH)
- …billings, and utilization , as needed; this may include working with payment authorization specialists (PAS); + Submits prior authorizations prior to the ... is available for consultation with primary "on-call" SSA; + Each SSA Supervisor has responsibilities and project assignments relative their expertise and the unit… more
- WEG Electric Corp. (Duluth, GA)
- Accounts Payable Supervisor /Management Accountant **Department:** Finance **Location:** Duluth, GA About the role: ... (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req\_id=3477150&source=3477150-CJB-0) The Accounts Payable (AP) Supervisor -Management Accountant will primarily oversee a small team of… more
- US Tech Solutions (Canton, MA)
- …reviewing, processing and managing the daily caseload of pharmacy and medical prior authorization (PA) requests for coverage determinations and exceptions. The ... **Job Descriptions** + Under the direction of the Pharmacy Utilization Management (UM) Supervisor , the Clinical Pharmacist...Clinical Pharmacist consults as required with Medical Directors on prior authorization that fails to meet drug… more
- Point32Health (MA)
- …requests + Achievement of expected productivity goals + Review of all assigned prior authorization requests including but not limited to inpatient admissions, ... referrals, outpatient procedures, VNA or outpatient therapies as specified in the prior authorization list using specified clinical criteria sets. + Concurrent… more
- Commonwealth of Pennsylvania (PA)
- …Minimum Experience and Training Requirements: + Two years as a Registered Nurse Supervisor or three years as a Registered Nurse Instructor (Commonwealth job title or ... illness, or developmental disability. Special Requirements: + This position requires active authorization to practice as a Registered Nurse in Pennsylvania. + If you… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Specialist provides administrative support for any of the programs of Utilization Management, Behavioral Health, Quality Management, or Member Care Management. This ... division. + Serves as the primary contact for providers regarding authorization , information requests, claim inquiries and benefits. Provides triage assistance to… more
- Air National Guard Units (Eielson AFB, AK)
- …Air National Guard. PDCN: D2180P01 / D2181P01 MPCN: 889707 Selecting Supervisor : James G. Meyer Responsibilities GS-09 - Administers classified and unclassified ... and software and develops base wide network operating procedures. Analyzes LAN utilization statistics through data collection and performance measures to ensure the… more
- Point32Health (Canton, MA)
- …responsible for reviewing, processing and managing the daily caseload of pharmacy prior authorization (PA) requests for coverage determinations (CD), and ... . **Job Summary** Under the direction of the Pharmacy Utilization Management (UM) Supervisor , the Clinical Pharmacist...consults as required with THP Medical Directors (MD) on prior authorization that fails to meet drug… more
- UPMC (Pittsburgh, PA)
- …to pharmacy prior authorizations. Manage the first line clinical review of prior authorization requests on behalf of physicians and UPMC Health Plan members. ... and the clinical staff + Subject matter expert on formulary exceptions and prior authorization requirements/time frames according to line of business. + Perform… more
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- …follows a capabilities model to achieve goals for eligibility, referral and authorization , care coordination, and utilization management to ensure improved ... improving the Veteran's experience and outcomes. Defines mental health policies, utilization management process and procedures, financial and utilization reports… more
- UPMC (Pittsburgh, PA)
- …goals. Do you have acute care authorizations or nursing experience? Do you have prior supervisor or management experience? If so, this could be the next ... is responsible for the direct oversight of the day-to-day operations of the authorization , denial management, and/or utilization review functions of UPMC Revenue… more
- Army National Guard Units (Lincoln, NE)
- …Deactivation, and Transformation. Identifies, analyzes, and provides recommendations to supervisor on significant issues and problems related to work accomplishment. ... comprehensive reports and recommendations with any corrective action taken to supervisor . Follows-up to ensure complete and quality resolution of discrepancies.… more
- Beth Israel Lahey Health (Westwood, MA)
- …and master an understanding of product and payer reimbursement landscape and prior authorization guidelines and processes. Collects and communicate all data ... needed to facilitate prior authorization approvals. Convey status updates as...not limited to), delivery, vaccination, synchronization and mobile app utilization . + Handle returns of merchandise and immediately notify… more
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