• Manager , Utilization

    Humana (Frankfort, KY)
    …and help us put health first** The Manager , Behavioral Health Utilization Management uses clinical knowledge , communication skills, and independent ... department. **_Detailed Responsibilities include:_** Leads Kentucky Medicaid Behavioral Health Utilization Management process and teams responsible for… more
    Humana (04/26/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...in utilization management and appeal/denial management . + Holds a strong working knowledge more
    Beth Israel Lahey Health (04/29/25)
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  • Manager , Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning. + ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… more
    Stanford Health Care (02/22/25)
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  • Mkt Manager Utilization Mgmt - Texas…

    Catholic Health Initiatives (Houston, TX)
    **Responsibilities** The Utilization Management (UM) Manager is responsible for managing day-to-day UM operations within the markets, focusing on effective ... medical necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management , performing essential duties… more
    Catholic Health Initiatives (05/04/25)
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  • Utilization Management

    UCLA Health (Los Angeles, CA)
    …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager more
    UCLA Health (03/04/25)
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  • Manager , Utilization

    CoreCivic (Brentwood, TN)
    …position will pay $82,000 - $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management /Case Management provides Utilization ... standards, and government laws and regulations. + Manages a team of utilization management nurses.Provides direction and supports staff in the development… more
    CoreCivic (04/29/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
    Beth Israel Lahey Health (04/16/25)
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  • Per Diem RN Case Manager

    Children's Hospital Boston (Boston, MA)
    79378BRJob Posting Title:Per Diem RN Case Manager , Utilization Management /ReviewDepartment:Patient Services-Patient Care ... Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem… more
    Children's Hospital Boston (05/01/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management more
    Helio Health Inc. (05/02/25)
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  • Registered Nurse Care Manager

    Catholic Health (Buffalo, NY)
    … or Disease Manager , Population Health, Discharge Planning or Chronic Care Manager KNOWLEDGE , SKILL AND ABILITY + Strong clinical assessment skills and ... to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of... Review, as an active member of the Care Management and interdisciplinary care team, provides comprehensive Utilization more
    Catholic Health (05/01/25)
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