Utilization Management Supervisor jobs

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UTILIZATION MANAGEMENT SUPERVISOR NON CLINICAL

Paid Days Off from Day One. Student Loan Repayment Program. Career Development. Whole Person Wellbeing Resources. Mental Health Resources and Support. AdventHealth Pepin Heart Institute, known across the country for its advances i...

Company	Adventhealth Tampa
Address	Tampa, FL
Category	Healthcare
Salary	$24.60 - $36.90 an hour
Job type	Full-time
Date Posted	a month ago See detail

Utilization Management Supervisor Non Clinical

Adventhealth Tampa

Tampa, FL

$24.60 - $36.90 an hour

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Supervisor, Transaction Accounting & Security Risk Management

Otter Tail Power Company

Fergus Falls, MN

Competitive Wage

* Review and own process narratives to ensure all controls are fully implemented and functioning as designed.Qualifications* Bachelor's degree in Accounting, Business or Finance or equivalent, relevant experience is required. * Re...

7 days ago seen See more...

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Utilization Management Nurse, Senior New

Blue Shield Of California

Rancho Cordova, CA

$87,230 - $130,900 a year

Perform clinical claim reviews and first claim level determination approvals for members using FEP evidenced based guidelines, policies and nationally recognized clinal criteria Conducts clinical review of claims for medical neces...

4 hours ago seen See more...

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RN Director Utilization Management ACM - Now Hiring New

Ascension

Texas, United States

Department: Case Management. Schedule: Full Time Day Shift. Hospital: Network Services. Location: Seton Administrative Offices. Ensure integration of Utilization Management functions with network strategy and claims processing. O...

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RN Utilization Management Nurse - Remote in OR New

Optum

Portland, OR

Consistently exhibits behavior and communication skills that demonstrate Optums commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Perform all function...

20 hours ago seen See more...

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Prior Authorization Utilization Management Nurse Consultant

Cvs Health

Austin, TX

Must have active, current and unrestricted compact RN licensure in state of residence. 3+ years of clinical experience. Must be wiling and able to work Monday through Friday 8am to 5 pm CST with occasional weekend/holiday on-call....

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RN Managed Care Coordinator I (Utilization Management) New

Bluecross Blueshield Of South Carolina

South Carolina, United States

This position is full time (40 hours/week) Monday-Friday and will be fully remote (W@H). To work from home, you must have high-speed (non-satellite) internet service and a private home office. Work hours: 8:00 am to 5:00 pm, Monda...

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Supervisor, Utilization Management

Altais

Oakland, CA

Supervises and coordinates activities of utilization review staff in maintenance of informed policy and procedure manuals, files, records and correspondence. Provide guidance on issues related to referral and authorization process...

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RN Supervisor Utilization Management

Dignity Health Medical Foundation

Rancho Cordova, CA

Under general supervision this position is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to ensure requests are processed in a consistent and timely manner while observing regulatory g...

2 months ago seen See more...

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Registered Nurse, Utilization Management

Thoughtwave Software And Solutions

Baltimore, MD

$34.79 - $46.00 an hour

Concurrent review of patients clinical information for efficiency. Ongoing review of precertification requests for medical necessity. Monitor the activities of clinical and non-clinical staff. Coordinates patients discharge plan...

3 days ago seen See more...

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RN - Utilization Management Nurse 2 - Remote - Florida Region

Humana

Indiana, United States

$69,800 - $96,200 a year

Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action 3-5 years of prior clinical experience preferably in an acute care hospital, skilled or rehabilitation clinical setting Comprehensive knowledge...

3 days ago seen See more...

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RN - Telephonic Utilization Management Nurse- Medicare- Remote - Southeast Region

Humana

Indiana, United States

$69,800 - $96,200 a year

Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Coordinates and communicates with providers, members, or other parties to facilitate appropriate discharge planning i...

3 days ago seen See more...

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Utilization Management Behavioral Health Professional Medicaid

Humana

Indiana, United States

Degree in Nursing or a Master's degree in a Behavioral Health-related field, such as Social Work, Counseling, or Psychology from an accredited university Must be licensed Registered Nurse or a licensed Masters Level Licensed Beha...

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Assurance (audit/review/compilation) Senior/Supervisor/Manager

Patrick & Raines, Llc

Lorida, FL

Leadership: Manage and complete audits, reviews, compilations, and agreed-upon engagements, setting the highest standards for quality. Innovation: Develop and implement auditing procedures and programs to stay at the forefront of...

4 weeks ago seen See more...

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Utilization Management Representative I

Elevance Health

ROANOKE, VA

Managing incoming calls or incoming post services claims work. . Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requ...

4 days ago seen See more...

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Supervisor, Health Information Management

Breg, Inc.

Huntsville, AL

$55,500 - $72,600 a year

Responsible for managing, supervising, and training the Health Information Management Team. Including schedule management, achievement of KPIs, competencies and holding the employees accountable for following all Breg policies, p...

4 weeks ago seen See more...

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Weekend Circulation Manager (Library Supervisor)

Valparaiso University

Valparaiso, IN

Open the building on Saturdays and Sundays. Close and secure the building on Saturday nights. During weekends, manage the day-to-day activities of the Circulation and Media Desks. Share management of the Automated Storage and Retr...

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Health Information Management (HIM) Coding Supervisor

Rush University Medical Center

Chicago, IL

RHIA, RHIT, and/or CCS Certification required....

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RN - Utilization Management Nurse 2 - Remote - Florida Region

Humana

Vermont, United States

$69,800 - $96,200 a year

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PCS Case Manager/Utilization Review Nurse

Adams Health Network

Decatur, IN

Registered Nurse...

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Prior Authorization Utilization Management Nurse Consultant

Cvs Health

Frankfort, KY

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

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Utilization Management Clinician - Behavioral Health

Pacificsource Health Plans

Bend, OR

Collect and assess member information pertinent to members history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services. Coordinate necessary resources t...

2 weeks ago seen See more...

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Utilization Management Nurse

Blue Eagle Consulting

Birmingham, AL

Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews. Current Nursing License and in good standing Prior Authorization and UM expert NCQA and InterQual expertise preferred Facets exper...

2 weeks ago seen See more...

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Utilization Review Nurse Manager

Community Alternatives Inc

Charlotte, NC

$65,000 - $95,000 a year

Dental insurance. Health insurance. Life insurance. Paid time off. Retirement plan. Vision insurance. 8 hour shift. Monday to Friday. Please list you RN license number? What types of patients have you primarily worked with in your...

4 days ago seen See more...

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Registered Nurse-Utilization Management

Department Of Veterans Affairs

Louisville, KY

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

2 weeks ago seen See more...

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Manager, Utilization Management - Remote (Maine)

Martin's Point Health Care

Portland, ME

Ensures that utilization review programs and guidelines are aligned with current industry evidence-based practice, as well as local, national, and regulatory compliance standards Manages the utilization review operations of the He...

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Wound Care Certified Home Health Utilization Management Nursing, RN

Centerwell Home Health

Tampa, FL

$69,800 - $78,700 per year

Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.Use your skills to make an impact Typically requires Bachelors degree or e...

2 weeks ago seen See more...

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RN Utilization Management - Per Diem

The Guthrie Clinic

Sayre, PA

$85.1K - $108K a year

Coordinate and facilitate correct identification of patient status.Collaborate and set standards with registered nurse (RN) case managers (CMs) and outcome managers to ensure that all hospitalized patients have the correct admissi...

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RN Care Coordinator, Utilization Management -Per diem - Days

Hackensack Meridian Health

Hackensack, NJ

$81.2K - $103K a year

BSN or BSN in progress and/or willing to acquire within 3 years of hire or transfer into the position. Effective decision-making skills, demonstration of creativity in problem-solving, and influential leadership skills. Excellent...

2 weeks ago seen See more...