- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR ...for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform the ... I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 -… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
- AmeriHealth Caritas (LA)
- …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
- AmeriHealth Caritas (Washington, DC)
- …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,… 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. ... to reassign staff based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and Nursing Leadership in identifying… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a ... to the Utilization Management Manager. * Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas,… 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
- Mount Sinai Health System (New York, NY)
- …State & Federal regulation. + Enters concurrent review information for Review Nurses in Allscripts + Obtains/Prepares Medical Records and other documentation ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...record keeping. Responsible for accurate filing of records, obtaining medical records and mailing of both internal and external… more
- Molina Healthcare (Tacoma, WA)
- …Licensed Practical Nurse (LPN) Program. **Required Experience** + 3+ years hospital or medical clinic experience. + 2+ years utilization management experience. + ... including rotational holiday and weekend on-call coverage (manager and supervisor will rotate) Remote position **KNOWLEDGE/SKILLS/ABILITIES** + Oversees an… more
- State of Massachusetts (Boston, MA)
- …will ensure compliance with all State and Federal regulations related to utilization review and discharge planning, while promoting effective, ethical, and ... trends in overuse, underuse, and inefficiencies, and report findings to the Utilization Review Committee. * Design and lead educational programming-including… more
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