• Vice President, Population Health & Clinical…

    Centene Corporation (Carson City, NV)
    …to target unique populations. + Leadership. + Oversees performance of all UM functions (prior authorization, concurrent review) for the market per the defined ... with 5+ years of relevant experience required. Master's Degree preferred. License: RN Required Candidate must have or become licensed in California. Pay Range:… more
    Centene Corporation (08/17/25)
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  • Chief Ultrasound Technologist, Cardiovascular…

    University of Miami (Miami, FL)
    …compliance to policies and protocols of the Cardiac Ultrasound section and UM service standards and Direcct Values Perform and train complex specialized tasks ... checklist: + Adults + Geriatric + Challenged/Disabled + Ensures Cardiac Echo techs, RN , performs basic nursing functions in the patient's care ie, assists with… more
    University of Miami (08/08/25)
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  • Coord Quality & Care Mgmt

    Covenant Health Inc. (Sevierville, TN)
    …Quality and Care Management. The Coordinator, in collaboration with the manager and the nurse manager is a leader, innovator and change agent in pursuit of seamless ... meetings and other venues, as required. + Serves as a Liaison between UM and Quality and Care Management. + 7.Tracks data related to Performance Improvement… more
    Covenant Health Inc. (07/30/25)
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  • Case Manager - Care Management, Per Diem

    Dartmouth Health (New London, NH)
    …days of admission. Initiates discharge planning process. Maintains communication with UM coordinator regarding assessments, outcomes, and projected lengths of stay. ... * Graduate of an accredited school of nursing and licensed to work as an RN in the State of NH * Area of Interest:Allied Health/Clinical; * Pay Range:$28.96 -… more
    Dartmouth Health (07/28/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …contractual changes from the Managed Care Department and applies to UM and appeals management processes. Works collaboratively with physicians, physician office ... Graduate of an accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing or Health preferred. Minimum… more
    Catholic Health Services (07/24/25)
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  • Quality Management Nurse Consultant

    US Tech Solutions (RI)
    …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech… more
    US Tech Solutions (07/18/25)
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