- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Lourdes Health (Pasco, WA)
- …fosters an environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning and swing ... Registered Nurse (RN), House Supervisor Job Type:...Registered Nurse (RN), House Supervisor Job Type: Full Time Days Wage scale:...an employee, but as a person. As a registered nurse (RN) joining our team, you're embracing a vital… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH Read on to fully understand what this… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... to experience, education, and other business and organizational considerations. Department: Utilization Management - UH FTE: 0.50 Part Time Shift: Weekend Days… more
- Battelle Memorial Institute (Columbus, OH)
- …+ Under the supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health ... covered by policy statements or published regulations to the Government supervisor + Observe patients to detect behavior patterns and reports observations… more
- 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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Centene Corporation (Sacramento, CA)
- …perspective on workplace flexibility. **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… more
- Saint Francis Health System (OK)
- …reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to ... levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate...nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location:… more
- CareFirst (Baltimore, MD)
- …accreditation standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft Office ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials....Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- MyFlorida (Chattahoochee, FL)
- REGISTERED NURSE SUPERVISOR - 60005446 Date: Dec 4, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career Service Position Number:… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion to retain requests for… more
- University of Utah Health (Salt Lake City, UT)
- …reassign staff based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and Nursing Leadership in identifying ... + Coordinate and communicate real-time staffing changes in conjunction with the Hospital Supervisor . + Review open shift requests and secure coverage as needed.… more
- State of Colorado (Denver, CO)
- Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental Health Hospital Fort Logan Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5132944) Apply Off Hours Nurse Supervisor - Nurse III (Internal Pool) - Colorado Mental… more
- HCA Healthcare (Manchester, NH)
- …we encourage you to apply for our PRN House Supervisor RN Registered Nurse opening. We review all applications. Qualified candidates will be contacted for ... have the PRN career opportunities as a(an) PRN House Supervisor RN Registered Nurse you want with...meetings with hospital staff to identify and communicate bed utilization issues . With inpatient coordinators and clinical staff… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt… more
- Bassett Healthcare (Cooperstown, NY)
- …specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Operating Room / Perioperative Services unit ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Northwell Health (Bay Shore, NY)
- …of patients admitted to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases with the Supervisor ... care patterns or cases and make referrals to the Supervisor and the department involved. + * Performs retrospective...as required. + * Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as… more
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