• Supervisor , Utilization

    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
    LA Care Health Plan (07/08/25)
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  • Supervisor ED Utilization

    AdventHealth (Tampa, FL)
    …such as heart failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management RN Supervisor reports directly to the Divisional ... members will have defined reporting accountabilities directly to Supervisors. The Utilization Management RN Supervisor is responsible for the daily… more
    AdventHealth (08/08/25)
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  • RN Supervisor UM Prior Auth

    Dignity Health (Rancho Cordova, CA)
    …Summary:** Under the guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is responsible and accountable ... sets (Medicare Guidelines InterQual Health Plan Benefit Interpretation Guidelines and Medical Management Policies and DHMF Utilization Management guidelines… more
    Dignity Health (06/20/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (LA)
    …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... and efficiency metrics in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon to: + Conduct utilization more
    AmeriHealth Caritas (06/25/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Washington, DC)
    …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
    AmeriHealth Caritas (06/03/25)
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  • Utilization Review Nurse Supervisor

    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
    The County of Los Angeles (05/22/25)
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  • Supervisor , Care Management

    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
    Hackensack Meridian Health (07/30/25)
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  • Utilization Management Reviewer

    Commonwealth Care Alliance (Boston, MA)
    …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical ... and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
    Commonwealth Care Alliance (07/31/25)
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  • Staff Utilization Coordinator

    University of Utah Health (Salt Lake City, UT)
    … to reassign staff based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and Nursing Leadership in identifying ... and trust that are integral to our mission. EO/AA_ The Staff Utilization Coordinator is responsible for providing healthcare operational support services, including… more
    University of Utah Health (08/07/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
    Helio Health Inc. (08/08/25)
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