- 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
- Alameda Health System (Oakland, CA)
- Clinical Nurse V + Oakland, CA + Highland General Hospital...MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + FTE:1 + ... on each nursing unit for which responsible. Promotes effective and economic utilization of personnel and supplies. Monitors utilization of personnel and… more
- Alameda Health System (Oakland, CA)
- Clinical Nurse IV + Oakland, CA + Highland General Hospital + Emergency + Full Time - Night + Management + TBD + Req #:43134-32050 + FTE:1 + Posted:November 4, ... of Administration during after hours, weekends, and holidays. Resource for the supervisor is the Administrator on-call; assumes a leadership role within the hospital… more
- Good Samaritan (Watertown, SD)
- …providers to plan, implement and evaluate care. Includes personal care management , medication administration, care planning, scheduling physician visits, setting up ... in the functions of the applicable technical software setting and process/ utilization improvement. Assists and supports human resources administrative processing and… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Battelle Memorial Institute (Columbus, OH)
- …operations and high-quality patient care. **Responsibilities** + Assist with the management and treatment of outpatient behavioral health activities + Under the ... supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health interventions… 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
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I...SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48… 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 ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
