• 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,...a Remote position with travel expectations. **About You** + Registered Nurse preferred + Bachelor's degree preferred… more
    Gentiva (04/19/25)
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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)
    …with documentation standards, policies, procedures and/or guidelines **Minimum Qualifications:** + Licensed registered nurse in the state of Iowa. + Bachelor's ... Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case...of hire + Five years of experience as a registered nurse involving community contact, knowledge of… more
    Trinity Health (04/19/25)
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  • Utilization Mgmt Case Manager FT

    LifePoint Health (Gallatin, TN)
    …or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin* ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of...- Case Management Minimum Education Associate's, Bachelor's degree or RN Diploma in Nursing - Required Required Skills Requires… more
    LifePoint Health (04/28/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at Home Care ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse ...the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience… more
    Beth Israel Lahey Health (04/16/25)
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  • Manager - Utilization Review…

    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 ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
    Beth Israel Lahey Health (04/29/25)
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  • Manager , Utilization Management…

    Humana (Frankfort, KY)
    …of experience working in Utilization Management processing clinical authorizations + Licensed Registered Nurse ( RN ) in the state of Kentucky (or compact ... part of our caring community and help us put health first** The Manager , Behavioral Health Utilization Management uses clinical knowledge, communication skills,… more
    Humana (04/26/25)
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  • Professional Care Manager

    UPMC (Hanover, PA)
    …required with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... **UPMC is hiring a part time Professional Care Manager for our Utilization Review department...preferred. **Licensure, Certifications, and Clearances:** Current licensure as a Registered Professional Nurse either in the state… more
    UPMC (04/17/25)
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  • Utilization Management Manager

    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 ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more years of… more
    UCLA Health (03/04/25)
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