- Daiichi Sankyo, Inc. (Bernards, NJ)
- …develop a cross-functional, integrated study plan and create initial study budget. Review study feasibility assessments provided by the CRO(s), lead the CRO ... risk related plans and ensure study team adherence and utilization . Be aware of and be able to predict...for resource management within their therapeutic area. Management requires review of resources against development pipeline to identify areas… more
- Merck & Co. (Durham, NC)
- …Process Monitoring, Sampling, and area cleaning. AccountabilityFirst line operations supervisor with a team of individual contributor production direct reports ... culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply -… more
- Merck & Co. (Durham, NC)
- …Drug Product Operations Manager Accountability - Project SupportFirst-line operations supervisor with a team of individual contributor production direct ... culture by reducing waste and constantly driving continuous improvement-- Review and approve compliance documents, as per procedures or need.Supply/Support… 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 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
- 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)
- …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
- 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...compliance, clinical management, patient progression, gathering and reporting of utilization data, community outreach and as a resource in… 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
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