- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The Manager , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support ... Primary Responsibilities + Coordinate day to day operations of the Utilization Management team. + Serve as the primary contact for day-to-day operational… more
- 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 ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- Elevance Health (Waukesha, WI)
- **Title:** Manager II Utilization Management **Hybrid 2:** This role requires associates to be in-office **3** days per week, fostering collaboration and ... unless an accommodation is granted as required by law. The ** Manager II Utilization Management ** is responsible for overseeing workflow and performance… more
- CVS Health (Little Rock, AR)
- …**Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and ... Registered Nurse. + 3+ years of Managed Care experience. + 3+ years of Utilization Management experience. + 1+ year Leadership experience (formal or informal… 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 ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and... Management I leads and collaborates with care management operations across utilization review, acute and… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230272/case- manager utilization - ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230024/case- manager -%28rn-%29 utilization - ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more