- State of Minnesota (Vadnais Heights, MN)
- **Working Title: Utilization Management Supervisor ** **Job Class: State Program Administrator, Director** **Agency: Direct Care and Treatment** + **Job ID** ... our DCT Quality Team for an exciting and rewarding opportunity as a Utilization Management Supervisor ! This position will work across DCT in partnership with… 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
- Molina Healthcare (Los Angeles, CA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... **Essential Job Duties** * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print... Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually Location Los… more
- 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 areas of ... years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting required + Leadership and/or … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...+ Preceptor Pay - $2.50 per hour + House Supervisor Pay - $4.00 per hour + Charge Nurse… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
- AmeriHealth Caritas (Washington, DC)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Actalent (Sunrise, FL)
- …Health Utilization Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... Prepare and present reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental Health + Clinical review… more