- Centene Corporation (Austin, TX)
- …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 to performance, compliance, quality, and efficiency standards. + Collaborates with utilization management team to resolve complex care member issues. +… more
- Centene Corporation (Sacramento, CA)
- …Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency 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, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates the activities of Inpatient Management Clinical ... Licensure and/or Compact State Licensure. **Experience:** 5 years experience in Utilization Management or Case Management at CareFirst BlueCross BlueShield,… more
- RTX Corporation (Cedar Rapids, IA)
- …400 Collins Rd NE , Cedar Rapids, IA, 52227 USA **Position Role Type:** Hybrid **U.S. Citizen, US Person, or Immigration Status Requirements:** Must be authorized to ... to join our **RTX Enterprise Services** team: The **Senior Supervisor ** is a part of the **Service Center Leadership...and leader guidance related to routine and complex people management activities across all business lines. + Manage day… more
- Child Communication and Behavior Specialists (CA)
- …neurodiversity-affirming, and culturally inclusive environment. The Position We are seeking a Hybrid BCBA Supervisor & Clinical Consultant to join our team. ... conducted in clinics or client homes. As a BCBA Supervisor , you'll: + Deliver impactful caregiver-mediated treatment (CMT). +...and successful client outcomes. + Ensure at least 90% utilization of recommended treatment hours. + Deliver a minimum… more
- Eversource Energy (Plymouth, MA)
- …productivity of district/substation operations\. Responsible for monitoring district performance through utilization analyses\. This is a hybrid role\. The first ... utilization and workload trends and productivity\. Keeps district/substation management informed of results\. + Identifies, develops and implements work process… more
- CenterWell (Tampa, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred ... action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market leaders on team-based...care field + 5 or more years of previous management / supervisor level experience + Proficiency in analyzing… more
- Eversource Energy (Westwood, MA)
- …interfaces, extracts, and partner systems\. + Responsible for project control management , roll\-up of schedule information, and integration with other support ... systems by providing analytical assessment for improving the utilization of schedules and expenditures, and issues organization reports \(scorecards\) that promote… more
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