• 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 (05/22/25)
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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 (03/30/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Washington, DC)
    …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
    AmeriHealth Caritas (06/03/25)
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  • Pediatric Shift Care Utilization Management…

    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
    AmeriHealth Caritas (05/22/25)
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  • Hybrid Utilization Management Nurse

    Actalent (Sunrise, FL)
    …cases, internal process development, and educates physicians and team members on utilization review issues. Ensuring smooth transitions and patient satisfaction ... Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a...present reports on department activities. Essential Skills + Clinical review + Utilization review +… more
    Actalent (06/11/25)
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  • Nurse Utilization Management…

    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
    Commonwealth Care Alliance (05/23/25)
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  • Supervisor , Utilization Management

    Centene Corporation (Jefferson City, MO)
    …flexibility. **_ Remote Role _** **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
    Centene Corporation (05/31/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Austin, TX)
    …WILL HAVE BCBA CERTIFICATION **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and ... of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
    Centene Corporation (06/12/25)
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  • Registered Nurse Supervisor B

    Louisiana Department of State Civil Service (Reserve, LA)
    REGISTERED NURSE SUPERVISOR B Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947288) Apply  REGISTERED NURSE SUPERVISOR B Salary ... as, Nursing Policy and Procedure Committee, patient safety, quality assurance, and utilization review . Supervises the ordering of medical supplies and materials… more
    Louisiana Department of State Civil Service (05/22/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Reserve, LA)
    REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947231) Apply  REGISTERED NURSE SUPERVISOR A Salary ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
    Louisiana Department of State Civil Service (06/07/25)
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