• Utilization Management

    Tufts Medicine (Burlington, MA)
    …assisting with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's ... This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In... Utilization Management Plan and… more
    Tufts Medicine (05/03/25)
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  • Coordinator, Utilization Management

    Evolent (Hartford, CT)
    Management reports directly to the Manager , Utilization Management . In support of our daily operations this individual also works with our ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
    Evolent (05/03/25)
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  • Manager , Utilization

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Manager , Behavioral Health Utilization Management uses clinical knowledge, communication ... 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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  • 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 ... determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management , performing...3. Oversee daily operations to ensure effective utilization reviews, strict adherence to denial management more
    Catholic Health Initiatives (05/04/25)
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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 ... services for select patient populations. Assists with daily hospital case management operations and is accountable for achieving established outcomes… more
    CoreCivic (04/29/25)
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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 Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
    Ascension Health (03/26/25)
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  • Case Manager (RN) - PRN Utilization

    Houston Methodist (The Woodlands, TX)
    …state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement and ... At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered...presents areas for innovation, efficiency and improvement in case management or department operations using evidence-based practice… more
    Houston Methodist (02/08/25)
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  • Supervisor, Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for... (UM) RN is responsible for executing the day-to-day operations of the UM department, and monitoring the Care… more
    LA Care Health Plan (04/11/25)
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  • Nurse- Utilization Management

    Veterans Affairs, Veterans Health Administration (Little Rock, AR)
    Summary Under the supervision of the Nurse Manager , the Utilization Management Nurse will ensure that patients meet appropriate admission and continued stay ... has been determined and implemented. Responsibilities Under the supervision of the Nurse Manager , the Utilization Management Nurse will ensure that patients… more
    Veterans Affairs, Veterans Health Administration (05/02/25)
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