- University of Rochester (Rochester, NY)
- …and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and management responsibilities for the pharmacy ... locations, and is intended to be a 'line manager ' level of responsibility, covering shifts typical of their...in hospital pharmacy administration + Graduate degree in business management (or another relevant field) Preferred ** KNOWLEDGE ,… more
- LA Care Health Plan (Los Angeles, CA)
- … of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health ... Utilization Management Nurse Specialist RN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- Prime Healthcare (Sherman Oaks, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization - management ... or management , preferred. + Current BCLS certificate preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Sherman Oaks… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - ... class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on denial … more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization ... year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS (AHA) certificate, preferred.5. Knowledge of Milliman… more
- Community Health Systems (Franklin, TN)
- …hospital revenue cycle preferred ** Knowledge , Skills and Abilities** + Strong knowledge of utilization management principles, payer guidelines, and ... appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued… more
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to...the state of New Jersey regulations for Nursing. **Education, Knowledge , Skills and Abilities Required:** + BSN or BSN… more
- CareFirst (Baltimore, MD)
- …business. ** Knowledge , Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM Salary ... we invite you to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of Connecticut (https://portal.ct.gov/) , Department of… more
- LifeCenter Northwest (Bellevue, WA)
- …a culture of collaboration, accountability, and continuous improvement across the organ utilization function. + Mentors and develops the manager (s) and lead ... Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that… more