- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a ... rotating weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall … more
- Stanford Health Care (Palo Alto, CA)
- …work-life balance while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager to further ... our robust, Utilization Management team. Are you driven by health care innovation, partnerships, and measurable results to improve the continuity of care… more
- Centene Corporation (Olympia, WA)
- …Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to ... member care , provider interactions, and facilitates operations within utilization management. + Manages prior authorization, concurrent review, and retrospective… 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 We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely response to… more
- 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 ... to remain current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound knowledge and skill… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... care + experience in an HMO environment + Thorough knowledge of health care industry, utilization review, utilization management, and concurrent review… more
- 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 ... care for caregivers and clinicians means better care for everyone, so we offer ongoing professional...to the Director of Utilization Management and is responsible for planning, coordinating, implementing,… more
- Houston Methodist (The Woodlands, TX)
- …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care ... At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered...utilization management, case management, performance improvement and managed care reimbursement. + Understanding of pre-acute and post-acute venues… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. ... range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes and… more
- Trinity Health (Mason City, IA)
- …Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case screening, insurance ... clinical disciplines. **What you will do:** + Works directly with members of care team to effectively ensure appropriate acute utilization management + Interacts… more