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Utilization Management Supervisor jobs

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CASE MANAGER/UTILIZATION REVIEW MANAGER - CASE MANAGEMENT

Seeks and provides peer consultation about cases presenting problems and/or experiencing significant deviation from the plan of care. Arranges for and participates in coverage during long, short, and unexpected absence of self and...

CompanyArnot Health
AddressElmira, NY
CategoryInformation Technology
Salary$40.56 - $51.55 an hour
Date Posted 2 weeks ago See detail

Case Manager/Utilization Review Manager - Case Management

Arnot Health

Elmira, NY

$40.56 - $51.55 an hour

Seeks and provides peer consultation about cases presenting problems and/or experiencing significant deviation from the plan of care. Arranges for and participates in coverage during long, short, and unexpected absence of self and...

2 weeks ago seen See more...

Utilization Mgmt Reviewer - System Care Management - Per-diem

The Guthrie Clinic

Sayre, PA

$42.8K - $54.2K a year

The Utilization Reviewer: Secures authorization as appropriate Documents payer authorization Screens the appropriateness of level of care/service Facilitates issue resolution with payer sources in collaboration with other...

2 weeks ago seen See more...

Utilization Managed Care Nurse

Access Healthcare Physicians, Llc

Spring Hill, FL

From $65,000 a year

401(k). Dental insurance. Health insurance. Life insurance. Paid time off. Vision insurance. 8 hour shift. Day shift. Monday to Friday. Medical records: 1 year (Preferred). CTST: 1 year (Required). RN: 5 years (Required). HEALTH P...

3 weeks ago seen See more...

Market Medical Director, Utilization Management - WellMed - Remote

Optum

San Antonio, TX

401(k)

Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values. Educates primary care physicians regarding systems, structures, processes and outcom...

3 weeks ago seen See more...

Case Manager Utilization RN ED Night 40/hr

Kaiser Permanente

San Marcos, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

2 weeks ago seen See more...

Case Manager Utilization RN, 40/hr Day

Kaiser Permanente

Anaheim, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

2 weeks ago seen See more...

Case Manager Utilization RN- Per Diem

Kaiser Permanente

Irvine, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

2 weeks ago seen See more...

utilization & case management educator (rn) - Baltimore, United States - LifeBridge Health

Lifebridge Health

United States

Description UTILIZATION & CASE MANAGEMENT EDUCATOR (RN)Baltimore, MDSINAI HOSPITALCARE MANAGEMENTFull-time - Day shift - 8:00am-4:30pmRN Other82791Posted:April 29, 2024Apply Now// Setting the Saved Jobs linkfunction setsavedjobs(e...

2 weeks ago seen

Case Manager Utilization RN- Per Diem Day

Kaiser Permanente

Fontana, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

2 weeks ago seen See more...

Nurse Manager - Utilization Management

Kaiser Permanente

Oakland, CA

Manages the operations of 24-hour departments that may be at multiple locations. Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal,...

3 weeks ago seen See more...

Utilization Management Assoc / Clinical Resource Management

Hartford Healthcare Corp.

Wethersfield, CT

$43.3K - $54.9K a year

Monitorsand manages assigned Utilization Management reports, including the Payer End ofDay report, Utilization Management list, Discharge Log, and the DischargeDisposition report for payers.. Monitorsand manages assigned EPIC work...

4 weeks ago seen See more...

Utilization Management Specialist

Kaizen Clinical Partners, Inc.

McAllen, TX

$44.9K - $56.8K a year

Analyze electronic medical records. Focus on evaluating the utilization of healthcare services, treatments, and procedures. Utilize retrospective reviews and other UM tools to identify opportunities for improvement and optimize pa...

4 weeks ago seen See more...

Utilization Management Specialist

Group Health Cooperative Of Eau Claire

Altoona, WI

$41.5K - $52.5K a year

Applies clinical experience, health plan benefit structure, health management policies and procedures, and claims payment knowledge to authorization reviews. Leverages clinical knowledge, business rules, regulatory guidelines and...

4 weeks ago seen See more...

Case Management Utilization RN, 40/hr Day

Kaiser Permanente

San Diego, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

3 weeks ago seen See more...

Case Manager Utilization RN, 40/hr Day

Kaiser Permanente

Irvine, CA

Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...

3 weeks ago seen See more...

Utilization Management Representative II

Elevance Health

Denver, CO

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...

a month ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Harrisburg, PA

$29.10 - $62.31 an hour

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

a month ago seen See more...

Utilization Management RN PRN Remote

Adventhealth Corporate

Altamonte Springs, FL

$34.78 - $52.17 an hour

Benefits from Day One. Career Development. Whole Person Wellbeing Resources. Mental Health Resources and Support. Facilitating precertification and payor authorization processes as required, ensuring proper authorization has been...

a month ago seen See more...

Utilization Management Representative II

Elevance Health

CHICAGO, IL

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

a month ago seen See more...

Utilization Management Clinician- Behavioral Health

Cvs Health

Austin, TX

3+ years post degree experience in a psychiatric or substance abuse setting required. -3 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care...

a month ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Hartford, CT

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...

a month ago seen See more...

Utilization Management Clinician, Behavioral Health

Cvs Health

Sacramento, CA

Gives providers determinations/recommendations along the continuum of care facilitates including effective discharge planning.- Coordinate with providers and other parties to facilitate optimal care/treatment.- Identify members at...

a month ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Springfield, IL

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...

a month ago seen See more...

Utilization Management Assoc / Clinical Resource Management

Hartford Healthcare

Wethersfield, CT

Monitors and manages assigned Utilization Management reports, including the Payer End of Day report, Utilization Management list, Discharge Log, and the Discharge Disposition report for payers. Monitors and manages assigned EPIC w...

a month ago seen See more...

Utilization Management Nurse - Dallas, TX

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required.. Minimum of two years Utilization Management acute care setting experience required. . Minimum of one-year drafting and submitting reco...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Columbus, OH

Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. We are health care innovators.Fundamentals:Through the use of cli...

2 months ago seen See more...

Utilization Management & Review Specialist

Med-Metrix

Parsippany, NJ

Serve as point of contact for client operational staff members impacted by UM/UR Processes. Track and monitor solutions implemented for clients and operational staff. Identifies system needs to support short and long term product...

2 months ago seen See more...

Utilization Management Associate

York State Department Of Labor

New York, NY

Process all incoming and outgoing correspondence/faxes in accordance with required standards and within respective timeliness guidelines.. Assist with initial screening of authorization requests. Generate and send emails using mai...

2 months ago seen See more...

Nurse IV (Utilization Management)

Department Of Veterans Affairs

Vancouver, WA

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 months ago seen See more...

Behavioral Health Utilization Management, Remote - Kansas License

Unitedhealth Group

Overland Park, KS

Manage facility-based admissions for mental health and substance abuse through the continuum of care. Effectively collaborate with treating providers and facilities to ensure consumers are receiving treatment in line with best pra...

2 months ago seen See more...

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