- Martin's Point Health Care (Portland, ME)
- …Summary The Supervisor is responsible for day-to-day operations of the utilization review team, which includes clinical and non-clinical staff, in the ... and authorization requests, organizational determinations/ disputes, and auditing/training of utilization review staff. Regularly monitors daily workload,… more
- Centene Corporation (Austin, TX)
- …perspective on workplace flexibility. **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… 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 ... collaboration with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services.… 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, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… 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 ...cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health… more
- Ryder System (St. Paul, MN)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Employee Services Supervisor is responsible for managing a team handling various...to get things done regardless of obstacles + Optimized utilization of resources to provide a delightful and consistent… more
- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager, Clinical Documentation ... to enhance clinical and coding skill sets and optimal utilization of the 3M CDI software. Responsible for scheduling...direct reports perform clinical validation as part of the review process and remain current on CDI strategies. Maintains… more
- Zeiders Enterprises, Inc (Woodbridge, VA)
- Description Job Title: Remote Contact Center Supervisor Zeiders is an industry leader in military and family support. Our company's reputation is based on ... we do and our commitment to quality service. Summary The Contact Center Supervisor is a full-time employee of Zeiders responsible for overseeing workforce planning… more
- University of Miami (Miami, FL)
- …via in-basket messaging. + Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions. CTU + Must possess ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- BrightSpring Health Services (San Antonio, TX)
- Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic Supervisor for Youth ABA Line of Business Salary: $75K PLUS BONUS ... FULLY LICENSED BCBA IN THE STATE OF TEXAS HYBRID REMOTE WORK AND FLEXIBLE SCHEDULE! We are seeking a...FLEXIBLE SCHEDULE! We are seeking a Youth Behavioral Clinic Supervisor that will be helping us build the Youth… more
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