- Sonora Quest (Sterling, CO)
- …the appropriate use of supplies and materials and assists with inventory management . Ensures efficient utilization of reagents and supplies. Recognizes and ... requirements (eg, CLIA '88, JCAHO, CAP, OSHA). Personnel report to department supervisor . May be responsible for the collection, receipt, and processing of… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day… more
- Centene Corporation (Atlanta, GA)
- …adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues + ... knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management team… more
- SSM Health (MO)
- … of daily operations within assigned region(s) or ministries related to the Utilization Management (UM) Review area under the direction of managers. Interacts ... Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Responsible for daily Utilization Management (UM) operations, which includes referrals, medical… more
- Centene Corporation (Madison, WI)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... adherence to performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH care member issues related to BH… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... standards and federal/state regulations and general principles relating to utilization review. + Computer skills, including Microsoft Office programs. +… more
- UCLA Health (Los Angeles, CA)
- …Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff ... schedules to efficiently handle incoming referrals and phone call volume. You will develop workflows, desktop procedures, forms, training materials, and protocols for achieving team objectives and key performance indicators. You will hire and train… more
- WellSpan Health (York, PA)
- …peer cases for need of retrospective external appeal-and funnel those cases to the Supervisor of Utilization Management for expedition. + Reviews cases ... Management staff. Duties and Responsibilities Essential Functions: + Renders utilization management determination in accordance with State and Federal… more
- The Cigna Group (Bloomfield, CT)
- Delivers specific delegated tasks assigned by a supervisor in Utilization Management . Handles moderately complex medical review, utilization review, ... appropriate course of action for treatment. May analyze treatment patterns and utilization trends. Contributes to the development and implementation of action plans… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. In this role as a Utilization Review Supervisor within our utilization department you would be responsible for ... services within NPH. This role entails overseeing a team of utilization review nurses, ensuring compliance with clinical regulatory standards, and enhancing… more
