- 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
- Ventura County (Ventura, CA)
- …the general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management. + utilize ... Senior Registered Nurse - Hospital Management Utilization Print...Supervisor Pay - $4.00 per hour + Charge Nurse Premium Pay - $1.50 per hour + Float… 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 (New York, NY)
- … Utilization Management** **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 to… more
- Saint Francis Health System (Tulsa, OK)
- …reimbursement issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to ... levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate...nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location:… more
- CareFirst (Baltimore, MD)
- …accreditation standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft Office ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN 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
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion to retain requests for… more
- AmeriHealth Caritas (Lafayette, LA)
- …ability to meet productivity standards in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse (RN) license ... **Role Overview:** Under the direction of a supervisor , the Utilization Management Reviewer evaluates...organization. + Proficiency in Electronic Medical Record Systems and Utilization Review Systems (eg, JIVA) to efficiently… more