- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Jul 15, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
- 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 ... managing the daily operation of the Utilization Management Review Nurse and...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time **Shift:** ... : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management , you...resource for navigating post-acute care services. **Minimum Qualifications:** + RN licensed by the State of Maryland or Compact… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management /ReviewDepartment:Patient Services-Patient Care ... a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current...preferred. Licensure/ Certifications: + Current Massachusetts license as a Registered Nurse ( RN ) + A… more
- Penn State Health (Hershey, PA)
- …and family medical or genetic information._ \#LI-TB1 IND567 **Union:** Non Bargained **Position** Manager Utilization Management - Utilization ... OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS...nursing required + Currently licensed to practice as a registered nurse by Pennsylvania Board of … 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 ... **Join Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff… more
- CareFirst (Baltimore, MD)
- …+ Proficient in Microsoft Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\ RN - Registered Nurse - State Licensure and/or ... week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages… more
- Commonwealth Care Alliance (Boston, MA)
- …Responsibilities: * The Utilization Management Reviewer reports to the Utilization Management Manager . * Conducts timely clinical decision review for ... facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy * Works… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while ... policies and guidelines. Responsibilities Major Duties (To include but not limited to): The Registered Nurse Utilization Management Registered … more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more