- 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
- AmeriHealth Caritas (LA)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... **Responsibilities:** 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. + Availability to work… 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
- BJC HealthCare (St. Louis, MO)
- …nurse experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization … more
- Elara Caring (Chicopee, MA)
- …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
- 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
- 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
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
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