- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 1, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the...for this role will have a bachelor's degree in nursing , public administration, public policy, public health or related… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and...Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233537/registered- nurse -case- manager ... KNAPP MEDICAL CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE...related field. At least one year experience in case management , discharge planning or nursing management… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...goals. **Requirements** + BSN is required. Master's Degree in nursing or related field preferred. + 5 years recent… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/229421/case- manager -%28rn%29 utilization - ... degree in a related field. At least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...and obtains observation status as appropriate. Partners with physicians, nursing , and other care providers to help ensure timely… more
- HonorHealth (AZ)
- …more at HonorHealth.com. Responsibilities Job Summary Under the direction of the Network Manager for Utilization Management , assists in the administration of ... Utilization Management functions to include, but not limited to, organization...requests and documents appropriately. Coordinates concurrent denial resolution with nursing and physician advisor team. Facilitates peer to peer… more
- Amergis (Sacramento, CA)
- Registered Nurse Case Manager - Utilization Management + Location: Sacramento, CA + Start Date: ASAP + Assignment Length: 13 Weeks + Openings: 1 + Weekly ... Friday Requirements: + Minimum 1 year of acute/inpatient case management experience + Prior utilization review experience...License + Basic Life Support (BLS) The RN Case Manager is responsible for coordinating continuum of care activities… more