Overview: To provide daily supervision of utilization management staff. Provide departmental leadership, support... feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring...
skills required. Computer literacy and proficiency. Familiarity with managed care and/or utilization management preferred..., training, evaluation and support to department staff in coordinating care and resource utilization. Serves as a role model...
Overview: The G&A Nurse Supervisor provides clinical and operational supervision to the Grievance & Appeals nursing... team, including Nurse Specialists, Sr. Nurse Specialists, and State Hearing Representatives. The Nurse Supervisor...
literacy and proficiency. Familiarity with managed care and/or utilization management preferred. Valid California driver... and assists the Team Manager and other Case Management Supervisors in developing and maintaining a cohesive team with a high level...
Overview: Under the direction of the Cost Avoidance Supervisor, the Cost Avoidance Specialist I monitors activities... on claims related to all lines of business; Research and identify overpayments related to over utilization of procedures...
prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility... the management, oversight, and operations within the pharmacy, including but not limited to: Living our purpose...