- 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 (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
- AmeriHealth Caritas (Dover, DE)
- …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
- BJC HealthCare (St. Louis, MO)
- … 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
- AmeriHealth Caritas (Philadelphia, PA)
- …us at www.amerihealthcaritas.com. **Responsibilities:** Under the direction of the unit Supervisor , the Clinical Care Reviewer- Shift Care is responsible for ... the case is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification and education to… more
- Actalent (Sunrise, FL)
- …cases, internal process development, and educates physicians and team members on utilization review issues. Ensuring smooth transitions and patient satisfaction ... Job Title: Utilization Management NurseJob Description The Utilization Management Nurse (UMN) plays a crucial...present reports on department activities. Essential Skills + Clinical review + Utilization review +… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Centene Corporation (Atlanta, GA)
- …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. **(Must reside in Georgia).** + Monitors and tracks UM… more
- Louisiana Department of State Civil Service (Jennings, LA)
- REGISTERED NURSE SUPERVISOR A/WAE/PRN Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4939641) Apply REGISTERED NURSE SUPERVISOR ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor (3rd Shift) - Warren State Hospital Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4933167) Apply Registered ... Nurse Supervisor (3rd Shift) - Warren State...the interdisciplinary team, and patient support services. As a supervisor , you will review all phases of… more