- 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 30, 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
- 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...+ Current MA RN Licensure required; Bachelor's degree in nursing , health care administration or related field preferred or… 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
- 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
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5)...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Actalent (Duluth, GA)
- Case management & Utilization management registered nurse opportunity! Description Nurse will be working on site. Responsibilities will include: Case ... Manager / Utilization Management (90%) and Discharge... Manager / Utilization Management (90%) and Discharge Planning. Develop...At least 1 year of case management /care management Must be a RN (Registered Nurse )… more
- Access Dubuque (Dubuque, IA)
- …Management and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management Nurse Cottingham & Butler/ SISCO CNA Psychiatric ... Utilization Management CNA **Cottingham & Butler/... Utilization Management CNA **Cottingham & Butler/ SISCO** 1 Positions...will also triage the call to determine if a Utilization Review Nurse is needed to complete… more
- Corewell Health (Grand Rapids, MI)
- …of insurance prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals ... optimal health within populations. Demonstrates expertise, current knowledge in nursing care and management of a caseload...management /managed care or related field Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...clinical nursing experience required + Experience in utilization review, case management , or discharge planning… more
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