• RN Care Manager

    Actalent (Seattle, WA)
    …in case management and care coordination. + Experience with EPIC software. + Utilization review and appeals handling capabilities. + Discharge planning and ... Job Title: RN Care Manager | Seattle, WA Job Description This role...including coordination and medication reconciliation, aiming to reduce emergency department visits and readmissions. The position involves handling all… more
    Actalent (07/28/25)
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  • VAS - Institutional Funds Manager

    CBRE (Boston, MA)
    VAS - Institutional Funds Manager Job ID 230919 Posted 29-Jul-2025 Service line Advisory Segment Role type Full-time Areas of Interest Valuations/Appraisal ... The Role:** As a CBRE VAS - Institutional Funds Manager , you will independently prepare market value appraisals on...of the property; conducting analyses and studies, eg, land utilization , supply and demand, economic feasibility, highest and best… more
    CBRE (07/30/25)
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  • Medical Director - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …leadership and direction to the functions within the Medical Management + Department ( Utilization /Cost Management and Quality Management) + Responsible for and ... **Facility:** Health Plan **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...+ Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager… more
    Sharp HealthCare (05/18/25)
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  • VAS - Institutional Funds Manager

    CBRE (Miami, FL)
    VAS - Institutional Funds Manager Job ID 215004 Posted 11-Apr-2025 Service line Advisory Segment Role type Full-time Areas of Interest Valuations/Appraisal ... - United States of America **About The Role:** As a CBRE Valuation Funds Manager , you will independently prepare market value appraisals on real estate assets with… more
    CBRE (07/18/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …errors, types and recurring issues. 4. Facilitates, coordinates and prepares denial appeals working with internal and external customers in a proactive manner to ... bring satisfactory resolution in coordination with other department staff 5. Relays denial information to appropriate billing clerks and management. 6. Follow up on… more
    Arnot Health (05/08/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …is expanding its **Care Transitions Department ** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ** Utilization ... clinical and reimbursement knowledge for optimal outcomes **RN Case Manager - Emergency Department UR & Discharge...or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management**… more
    Beth Israel Lahey Health (07/03/25)
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  • UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... ensure compliance with utilization management policies. This role conducts admission and continued...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
    Community Health Systems (07/29/25)
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  • Per Diem RN - Case Management - Sharp Grossmont…

    Sharp HealthCare (La Mesa, CA)
    …as appropriate in Cerner and Allscripts Care Management and provides information to the department head as indicated. + Utilization review and utilization ... **Facility:** Grossmont Hospital **City** La Mesa ** Department ** **Job Status** Per Diem **Shift** Day **FTE**...0 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager … more
    Sharp HealthCare (07/18/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …leadership and direction to the functions within the Medical Management Department ( Utilization /Cost Management and Quality Management) + Develops and ... **Facility:** Health Plan **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...as needed.Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager… more
    Sharp HealthCare (07/19/25)
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  • Medical Director, MSK Surgery

    Evolent (Jackson, MS)
    …to the support services review process. Responsible for the quality of utilization review determinations, including appeals . + Provides input into audit ... training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts… more
    Evolent (05/20/25)
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