- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Centene Corporation (Jefferson City, MO)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …coordinates and is accountable for the daily work of employees who provide utilization management , clinical and medical necessity claim related services and ... PT, NP, PA, or Dietician) with a minimum of three years of utilization management /quality improvement experience or equivalent required. + Must possess a… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization … more
- Amergis (Rancho Cordova, CA)
- Salary: $1760 / Week Supervisor Utilization Management PriorAuthorization Anticipated Duration: ASAP - 3 monthcontract Location Address: Rancho Cordova CA ... management experiencerequired Amergis Healthcare Staffing is seeking a Supervisor Utilization Management Prior Authorization responsible… more
- 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 ... Guidelines InterQual Health Plan Benefit Interpretation Guidelines and Medical Management Policies and DHMF Utilization Management...or experience equivalent required. - Clear and current CA Registered Nurse ( RN ) license. -… more
- AmeriHealth Caritas (LA)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...Bachelor's Degree in Nursing (BSN) preferred. + An active Registered Nurse ( RN ) license in… more
- AmeriHealth Caritas (Washington, DC)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... and weekends based on business needs **Responsibilities** + Conduct utilization management reviews by assessing medical necessity,...setting **Licensure** + Current driver's license required + A Registered Nurse ( RN ) license in… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …Advanced Cardiac Life Support acceptable in lieu of BLS) Medical-Surgical Nursing Certification RN -BC ( Registered Nurse - Board Certified) (preferred) CCRN ... ( RN ) - Med-Surg - Maryview Medical Center_** **Job Summary:** The Med-Surg Registered Nurse ( RN ) position is responsible for delivering exceptional… more
- Bon Secours Mercy Health (Greenville, SC)
- …and operational excellence. FT Nights **Summary of Primary Functions** The Critical Care Registered Nurse ( RN ) provides, coordinates, plans, and evaluates ... Nurse (preferred) PCCN Progressive Care Certified Nurse (preferred) RN -BC Registered Nurse - Board Certified (preferred) TCRN Trauma Certified… more
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