- 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 (New York, NY)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... perspective on workplace flexibility. **Must have an active New York State RN license.** **Inpatient Utilization Management ** **Position Purpose:**… more
- AmeriHealth Caritas (Lafayette, LA)
- …in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse ( RN ) license in Louisiana or multi state license ... **Role Overview:** Under the direction of a supervisor , the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure...5+ years of UM experience in a lead or supervisor role with a healthcare payor organization. Experience working… more
- AmeriHealth Caritas (LA)
- …Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity ... to 2 weekends per year **Education & Experience** + Registered Nurse candidates: Associate Degree in Nursing...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization ...Supervisor Pay - $4.00 per hour + Charge Nurse Premium Pay - $1.50 per hour + Float ... Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered Nurse - Hospital Management Utilization Salary… 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
- Avera (Pierre, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... License/Certification, or Work Experience:** + 1-3 years clinical experience as RN + supervisory or management experience **Expectations and Standards**… more