• Utilization Review Nurse

    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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...implemented for compliance, as needed. + As a unit supervisor at the LA General Medical Center: + Has… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse

    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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (06/28/25)
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  • Utilization Management Nurse

    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 team ... in a payer or managed care environment. + Strong understanding of utilization review , authorizations, and appeals processes. + Excellent verbal/written… more
    Integra Partners (08/26/25)
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  • Supervisor , Utilization Management

    Centene Corporation (Columbus, OH)
    …STATE OF OHIO IDEAL CANDIDATE WILL HAVE PRIOR AUTHORIZAION OR UTILIZATION MANAGEMENT EXPERIENCE PEOPLE LEADER EXPERIENCE STRONGLY PREFERRED **Position Purpose:** ... Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ...ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources… more
    Centene Corporation (08/23/25)
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  • Utilization Review Specialist Sr.

    BayCare Health System (Tampa, FL)
    …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials....Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (08/26/25)
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  • Registered Nurse Supervisor

    MyFlorida (Chattahoochee, FL)
    REGISTERED NURSE SUPERVISOR - 60005446 Date: Aug 13, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 858609 Agency: Children and Families Working Title: REGISTERED NURSE SUPERVISOR - 60005446 Pay Plan: Career Service Position Number:… more
    MyFlorida (09/10/25)
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  • Nurse Family Partnership Nurse

    University of Colorado (Colorado Springs, CO)
    Nurse Family Partnership Nurse Supervisor & Instructor - Clinical Practice - 37436 Faculty **Description** **The University of Colorado Colorado Springs will ... work visas or permanent resident applications for this position** ** Nurse Family Partnership Nurse Supervisor ...Oversees and ensures timely and accurate data input and utilization of the web-based reports and other reports available… more
    University of Colorado (08/08/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
    Mount Sinai Health System (07/23/25)
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  • Utilization Management Reviewer

    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
    AmeriHealth Caritas (09/01/25)
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  • RN Quality Review Nurse Home Health

    AdventHealth (Orlando, FL)
    …you'll contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight activities as defined by inter ... best practices, agency policies/processes. Ensures clear and appropriate visit utilization using evidence-based and best practice guidelines to achieve positive… more
    AdventHealth (09/10/25)
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