• Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
    UNC Health Care (05/01/25)
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  • Utilization Manager

    Gentiva (Mooresville, NC)
    …a lasting difference in people's lives every day. **Overview** We're looking for a ** Utilization Manager ** to join our team. This position will directly report ... to the Director of Utilization Management and is responsible for planning, coordinating, implementing,...PPD vendors: medical supplies, durable medical equipment, and pharmacy utilization . + Works closely with branch leadership to identify… more
    Gentiva (04/19/25)
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  • Utilization Manager -OASAS Program

    Samaritan Daytop Village (Rhinebeck, NY)
    …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: + Bachelor… more
    Samaritan Daytop Village (05/03/25)
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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 ... appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services at Helio… more
    Helio Health Inc. (05/02/25)
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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 team ... necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management, performing essential duties and… more
    Catholic Health Initiatives (05/04/25)
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  • Utilization Management Operations…

    Tufts Medicine (Burlington, MA)
    …assisting with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization ... payment processing. In addition, this role focuses on performing the following Utilization duties: Ensures the delivery of clinical services is appropriate and… more
    Tufts Medicine (05/03/25)
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  • Registered Nurse Care Manager

    Catholic Health (Buffalo, NY)
    …Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of the Care Management and ... foundational nursing clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with the interdisciplinary team to… more
    Catholic Health (05/01/25)
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  • Manager , Utilization Management/…

    CoreCivic (Brentwood, TN)
    …will pay $82,000 - $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management/Case Management provides Utilization Review and Case ... a responsibility to better the public good. CoreCivic is currently seeking a ** Manager , Health Services Audits** located at our corporate office in Brentwood, TN.… more
    CoreCivic (04/29/25)
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  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
    Catholic Health Services (03/19/25)
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  • Utilization Review Case Manager

    Trinity Health (Mason City, IA)
    …Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case screening, insurance ... Works directly with members of care team to effectively ensure appropriate acute utilization management + Interacts with outside review agencies and payors to inform… more
    Trinity Health (04/19/25)
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