- Fallon Health (Worcester, MA)
- …follow us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager, Prior Authorization RN manages all staffing and activities related to ... prior authorization which includes but is not...Authorization UM. + Oversees all activities of the Supervisor , PA RN and their direct and indirect reports… more
- Centene Corporation (Atlanta, GA)
- …between utilization management team, members, and providers + Monitors prior authorization , concurrent review, and/or retrospective clinical review nurses ... a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization , Concurrent Review, and/or Retrospective Review Clinical… more
- Actalent (Sunrise, FL)
- …direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing ... a liaison between the Medical Director, physicians, and office staff, resolving prior authorization issues. + Communicate denial determinations to providers when… more
- Commonwealth Care Alliance (Boston, MA)
- … Management Manager. * Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not ... and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
- Dignity Health (Rancho Cordova, CA)
- …and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is ... Summary:** Under the guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is responsible and accountable for… more
- Geisinger (Danville, PA)
- Job Summary Obtain and secure prior authorization for high end procedures,hospital scheduled admissions and/or specialty patients. Verifies and completes ... + Assists physicians, insurance companies, employers, and others with requests concerning prior authorization to result in positive resolution. + Coordinates… more
- Samaritas (Holland, MI)
- Position Details CLINICAL SUPERVISOR - HOLLAND AREA - MENTAL HEALTH / ADDICTION SERVICES Do you have a Master's Degree and are you a licensed clinician with a ... leading others? Join our mission-driven team as a Clinical Substance Use Disorder Supervisor , where your leadership will directly impact lives and shape the future… more
- ASM Global (Houston, TX)
- …north dock at NRG Stadium and NRG Center. + Ensuring all shipments received have prior authorization and verifying with the tenant any shipmentswithout prior ... has an excellent and immediate opening for a Dock Supervisor at NRG Park in Houston, Texas. NRG Park...Standards, applicable local codes and NFL's Best Practices. + Utilization of a variety of technological software, platforms, and… more
- State of Massachusetts (Boston, MA)
- …dynamic individual for the position of Human Services Coordinator II (CYF Case Manager Supervisor ) to join our Metro Boston Child, Youth, and Family team. The HSC-II ... to DMH clients. The HSC-II has the responsibility of monitoring performance and utilization of assigned Area-based CYF contracts and serving as a Service Integration… 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