- Tufts Medicine (Burlington, MA)
- …the design, development, implementation, and monitoring of the organization's utilization review functions. The position establishes the department's strategy and ... as the internal resource on issues related to the utilization of resources, coordination of care across the continuum...of resources, coordination of care across the continuum and utilization review and management. The position develops and leads… 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 SUPERVISOR ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location...as needed to assist with patient care coordination and utilization review. The incumbent will be responsible to assist… more
- Centene Corporation (Sacramento, CA)
- …PST- experience in CCR is highly preferred** **Position Purpose:** Directs the utilization management team to ensure the appropriate application of policy procedures ... and processes to help support best member outcomes. Oversees and manages Utilization Operations specific to the daily operations of Utilization Management… more
- Centene Corporation (Sacramento, CA)
- …team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence ... to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues + Maintains… more
- Centene Corporation (Phoenix, AZ)
- …and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Oversees and ... works with senior leadership on utilization management issues related to member care, provider interactions,...to member care, provider interactions, and facilitates operations within utilization management. + Oversees the behavioral health (BH) … more
- Beth Israel Lahey Health (Boston, MA)
- …lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status ... of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for… more
- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... with meeting the organization's goals and objectives for assuring the effective, efficient utilization of health care services. This role will be an expert on… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... achieved an expert level at all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
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