Responsable de Missions Audit clé dans l'audit légal et contractuel chez Exco Socodec. Supervisant les équipes et assurant la qualité des travaux, avec un portefeuille diversifié de clients.
About the role
- Utilization Review Manager overseeing daily review operations and compliance at Saint Alphonsus in Boise, Idaho. Providing supervisory leadership and collaborating with medical teams for optimal outcomes.
Responsibilities
- Oversee daily utilization review operations, serving as first point of escalation for issue resolution.
- Ensure compliance with payer and regulatory requirements.
- Provide supervisory leadership through scheduling, performance management, and guiding staff development.
- Direct utilization review workflows and medical necessity evaluations.
- Manage denial prevention, expedited appeals, and payer communication to secure authorizations.
- Collaborate closely with Physician Advisors, CRM Managers, and the multidisciplinary team to maintain reporting and optimize departmental processes.
Requirements
- Licensed in the State of Idaho as a Registered Nurse as defined by the Idaho State Board of Nursing.
- BSN required
- 5 or more years of experience in utilization review or case management or similar required.
- 2 or more years of supervisory experience required.
- American Heart Association Basic Life Support for HealthCare Provider (BLS/HCP) certification required
Benefits
- Day 1 Benefits – colleagues are eligible for our plans from their very first day of work.
- Market-competitive pay
- Generous PTO
- Retirement planning and matching
- College savings plans for your family
- Multiple life insurance plans
- Employee Assistance Programs
- Tuition reimbursement
- Educational opportunities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Task Order, Warranty and Repair Manager for Leidos managing CHS - 6 contract operations. Leading relationships and strategies for warranty and repair services with the U.S. Army.
Assistant Manager in Finance Data & Analytics Office managing data strategy alignment and operational demands. Collaborating across teams to implement change and improve customer outcomes.
Corporate Senior Quality Manager overseeing quality management systems, compliance, and continuous improvement across multiple business units. Driving quality culture and risk management initiatives in a regulated environment.
Manager Tender Desk leading the tender function for iBabs, ensuring successful participation in bids. Coordinating with various departments to enhance tender documentation quality and win ratios.
Senior Manager for Care Center Workforce Management at Truist leading strategy and governance. Overseeing performance and enhancing client experience at scale across various locations.
Administrative Services Manager providing support to the SOF AT&L Program Executive Office for Maritime. Managing program execution, documentation, meetings, and communications at MacDill AFB, FL.
Manager, Decision Science leveraging data expertise and statistical principles at Travelers. Driving business strategies through actionable insights and relationship building across departments.
Renewals Manager responsible for managing contract renewals and expansions at Kong. Contributing to the revenue growth in the Asia Pacific region.
Case Manager responsible for interdisciplinary coordination of patient care at PAM Health. Working collaboratively with the team to ensure effective care management and discharge planning.