- 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 ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Sep 26, 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...health care delivery for vulnerable populations and utilizes this knowledge in developing partnerships to ensure high-level of quality… more
- Centene Corporation (Phoenix, AZ)
- …state required licensure as outlined by the applicable state required. Strong knowledge of utilization management principles preferred. Advanced ... care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and facilitates… more
- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- 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
- Molina Healthcare (GA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... or more of the following activities: care review, care management , utilization management (prior authorizations,...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more
- CareFirst (Baltimore, MD)
- …practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care. + Knowledge of medical-necessity ... week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...to deliver financial results for areas of accountability * Knowledge of or ability to learn financial management… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …+ Demonstrates general understanding of coding standards + Maintains current and working knowledge of Utilization Management Standards. + Experience in ... depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of… more
- Amazon (Seattle, WA)
- …the AWS cloud. We're seeking an experienced Technical Infrastructure Program Manager to oversee data center electrical infrastructure optimization projects. The ... Technical Infrastructure Program Manager will lead cross-functional... will lead cross-functional and technical teams identify sub-optimal utilization , determine root causes, design solutions and drive project… more
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