- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …directly manages 8 to 13 workers + This role reports to this job: DIRECTOR, UTILIZATION REVIEW ;MANAGER, UTILIZATION REVIEW + Necessary Contacts: In order ... services are provided is required + Certification in Professional Coding, Utilization Review , Utilization Management, Quality Review , Case Management… more
- 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
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- Centene Corporation (Jefferson City, MO)
- …flexibility. **_ Remote Role _** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical 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… more
- Sedgwick Government Solutions (Charleston, SC)
- Job Details Utilization Review Case Manager RN (Remote) 2025-1434 Charleston, SC, USA Medical Services Full Time Description ** Utilization Review Case ... and support through our highly skilled team of home-based Utilization Review Case Managers. Are you looking...appropriate department. + Meets productivity goals as outlined by supervisor . + Maintains privacy, as per Program guidelines, within… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The position of Senior Utilization Review Manager is ... responsible for the oversight of third-party payer utilization review (UR), denial management (DM) processes...to the additional special projects. Working with the UR Manager/ Supervisor (s), a Senior manager functions as a subject matter… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
- St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
- …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... , supporting the agency's mission and client care quality. Department Utilization Review Employment Type Full-Time Minimum Experience Mid-level Compensation… 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
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