- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Centene Corporation (Tallahassee, FL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization … more
- Centene Corporation (Jefferson City, MO)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Tufts Medicine (Burlington, MA)
- … Review and Discharge Planning including implementation and annual review of the Utilization Management Plan and assisting with the coordination of the ... Utilization Management Committee. The ...and ensuring optimum outcomes. **Job Description** **Minimum Qualifications:** 1. Registered Nurse (BSN or higher) or other… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical ... organization, professional organizations, and community health care facilities concerning Utilization Management . + Participates in in-services and continuing… more
- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As ... 15, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN ...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
- Centene Corporation (Jefferson City, MO)
- …+ Expert knowledge of industry regulations, policies, and standards preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... to help support best member outcomes. Oversees daily operations of Utilization Management including timeliness, quality and performance outcomes, provider… more
Recent Jobs
-
Sentinel Principal DevOps Engineer
- Northrop Grumman (Roy, UT)
-
Senior Software Development Engineer in Test
- NVIDIA (Santa Clara, CA)
Related Job Searches:
Management,
RN,
RN Remote Utilization Management,
RN Utilization Case Management,
RN Utilization Management Review,
Supervisor Utilization Management RN,
Utilization,
Utilization Management,
Utilization Management Compliance RN,
Utilization Management Nurse RN