- Merck & Co. (Durham, NC)
- …complying with current Good Manufacturing Practices in the form of project management and ultimately shop floor leadership.-Key Responsibilities for a Drug Substance ... Manager Accountability - Project SupportFirst-line operations supervisor with a team of individual contributor production direct reportsSupports project team as… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day… more
- Centene Corporation (New York, NY)
- …**Must have an active New York State RN license.** **Inpatient Utilization Management ** **Position Purpose:** Supervises Prior Authorization, Concurrent Review, ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- AmeriHealth Caritas (Lafayette, LA)
- **Role Overview:** Under the direction of a supervisor , the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient ... making determinations based on clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services,… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print... Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually Location Los… more
- Hackensack Meridian Health (Edison, NJ)
- …a leader of positive change. The role of ** Supervisor , Care Management ** integrates and coordinates utilization management , care coordination, discharge ... acute care setting. + Familiar with hospital resources, community resources, and/or resource/ utilization management . + Care coordination, case management or… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...+ Preceptor Pay - $2.50 per hour + House Supervisor Pay - $4.00 per hour + Charge Nurse… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
- Saint Francis Health System (OK)
- …placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma 73105… more
- Saint Francis Health System (Tulsa, OK)
- …not all inclusive nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location: Tulsa, Oklahoma 74136 **EOE ... in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal… more
- Providence (Anaheim, CA)
- **Description** Under the direction of the Utilization Supervisor / Manager, this position is responsible for the distribution, review, accurate and timely ... Assistant Certification (CMA) upon hire. + 1 year - Experience in utilization management or case management with experience in medical terminology and… more
- Ascension Health (Baltimore, MD)
- …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for resources and removal of barriers. + Maintain ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan.… more
- Helio Health Inc. (Syracuse, NY)
- …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ourSyracuse… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.… more
- University of Rochester (Rochester, NY)
- …conduct the business of the functional unit under their supervision and management . Their supervisor should be aware of all ongoing interdepartmental ... defined by NYS Laws and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and...frequency of reporting will be agreed upon with their Supervisor . + Performs budget management and planning… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care of patients to facilitate achievement of positive ... care as appropriate. Participates in performance improvement initiatives related to the management of patient care. Works with physicians to ensure accurate and… more
- Mohawk Valley Health System (Utica, NY)
- RN Supervisor Case Management - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Supervisor Case Management - SNH is responsible ... for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision and… more
- Wawa, Inc. (IA)
- …Technology **Location:** Corporate **Department:** Facilities **Job Summary** **:** The Senior Supervisor of Building Management Systems is responsible for the ... Automation System (BAS) and to support the daily operations of the Facilities Management System. The position is responsible to manage relationships with the Contact… more
- Pacific Medical Centers (Renton, WA)
- …Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health ... and USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Providence caregivers are not… more
