- CVS Health (Phoenix, AZ)
- …of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven team that's ... or emergent interventions, including triage and crisis support. + Identify members for care management programs and facilitate referrals. + Promote quality and… more
- Centene Corporation (Jefferson City, MO)
- …experience required 10+ years of nursing, utilization management , or case management experience in an acute care setting required Experience in managed ... complex and often conflicting requirements. + Oversee the operations of utilization management , reconciliation coordination, concurrent review (telephonic and… more
- Martin's Point Health Care (Portland, ME)
- …Utilization Review Assistant is responsible for providing non-clinical support to the Utilization Management (UM) Team. This role supports the operation of ... Join Martin's Point Health Care - an innovative, not-for-profit health care...requests per standard work in order to ensure that Utilization Management activities are completed in a… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Supervisor of Utilization Management has an important role in a high-profile group tasked with implementing system-wide improvements and ... operational processes to ensure optimal and compliant utilization review strategies. Under minimal supervision from the Manager the Supervisor is responsible for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …coding standards + Maintains current and working knowledge of Utilization Management Standards. + Experience in interpreting managed care benefit plans and ... customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough...of care . + Collaborates with hospital, home care , care management , and other… more
- Adecco US, Inc. (Minneapolis, MN)
- …skills in the review and determination of coverage for medically necessary health care services. . Answers Utilization Management directed telephone calls; ... Nurses** ! This role is work from home and remote but we are requiring Nurses to live in...applicable states . 2+ years of experience in managed care , Utilization Review, Case Management … more
- UPMC (Pittsburgh, PA)
- The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Assistant **Cottingham & Butler/ SISCO** 1 Positions ID: 4755768008 Posted On 07/01/2025 **Job Overview** ** Utilization Management ... and thrive in a fast-paced, professional environment? We are seeking a dedicated ** Utilization Management Assistant** to join our healthcare team. This role is… more
- AmeriHealth Caritas (Newark, DE)
- …www.amerihealthcaritas.com. **Responsibilities:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical ... times, quality benchmarks, and efficiency metrics in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted… more
- Trinity Health (Silver Spring, MD)
- …time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time **Shift:** Day **Location** : ... Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management , you will be the key... and reduce unnecessary costs while maintaining high-quality patient care . + ** Remote Opportunity -** Must live… more
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