- 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
- Molina Healthcare (NM)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... at the right time. + Functions as a hands-on supervisor , coordinating and monitoring clinical and non-clinical team activities...in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Centene Corporation (Atlanta, GA)
- …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
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... ON BONUS** **Role Overview:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization ...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Current driver's license… more
- Dignity Health (Woodland, CA)
- …Woodland, CA, with occasional onsite meetings in Woodland.** **Position Summary:** The Utilization Review LVN uses clinical judgement in providing utilization ... position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilties may include: - Determines… more
- University of Utah Health (Salt Lake City, UT)
- …+ Coordinate and communicate real-time staffing changes in conjunction with the Hospital Supervisor . + Review open shift requests and secure coverage as needed. ... for both the Inpatient and Ambulatory Resource Department staff. Review patient census interface and staffing grids, adjusting daily...based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and… more
- Elara Caring (South Portland, ME)
- …productivity. + Assists staff in maintaining current and accurate medical records and utilization review . + Assists clinical supervisor with non-clinical ... phone inquiries. + Notifies supervisor of any problems requiring administrative attention and intervention. + Processes and distributes in and out daily mail for the department, collects and maintains inventory, and cleans equipment. + Implements all… 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)
- …Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization Management ... to the Utilization Management Manager. * Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas,… more