- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Jan 6, 2026 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...health care delivery for vulnerable populations and utilizes this knowledge in developing partnerships to ensure high-level of quality… 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...in utilization management and appeal/denial management . + Holds a strong working knowledge … more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... setting, management of direct reports preferred + Strong knowledge of utilization management principles, regulatory requirements, and payer requirements.… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… 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
- UCLA Health (Los Angeles, CA)
- …the 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 ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...to deliver financial results for areas of accountability * Knowledge of or ability to learn financial management… more
- Hartford HealthCare (Willimantic, CT)
- …Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other ... moment.* **Job:** **Nursing* **Organization:** **Windham Hospital* **Title:** *Registered Nurse Case Manager (RN) - Utilization Management * **Location:**… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... of the Utilization Review Plan and the overall operation of the Utilization Management Department in accordance with federal, state and local guidelines,… more
- John Muir Health (Walnut Creek, CA)
- …the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** + ... manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager ...Support - American Heart AssociationRequired + ACM Accredited Case Manager - ACMA American Case Management Association… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... experience strongly preferred **Skills and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and… more
- Elevance Health (CA)
- **Behavioral Health Care Manager I, Utilization Management ** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... granted as required by law. The **Behavioral Health Care Manager I, Utilization Management ** is...will make a difference:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to… more
- Logan Health (Kalispell, MT)
- …Excellence. Logan Health is looking for an RN to lead the way as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review! This role is ideal ... workflows with clarity. What You'll Be Doing: As the Manager of CDI & Utilization Review, you...manner + Partnering with the Chief Medical Officer on utilization review initiatives, length of stay management ,… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ourSyracuse ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management… more
- Ochsner Health (Jefferson, LA)
- …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- Cedars-Sinai (Los Angeles, CA)
- …Utilization Review Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category** : ... named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent… more
- University of Rochester (Rochester, NY)
- …and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and management responsibilities for the pharmacy ... locations, and is intended to be a 'line manager ' level of responsibility, covering shifts typical of their...in hospital pharmacy administration + Graduate degree in business management (or another relevant field) Preferred ** KNOWLEDGE ,… more
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