- Elevance Health (Washington, DC)
- …4 days each week. The office is located at 609 H. Street NE.** The **RN** ** Manager - Utilization Management ** is responsible for managing a team of physical ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing… more
- Baystate Health (Springfield, MA)
- … Manager / Utilization Management ** The **RN Hospital Case Manager ** is a registered nurse responsible for the coordination of clinical care, quality, ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...Experience:** + BSN Strongly preferred + 3-5 years clinical Nursing experience + Hospital Case Management , Care… 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...a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with… 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 ... professionals to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by… 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...for this role will have a bachelor's degree in nursing , public administration, public policy, public health or related… 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 ... RN licensure in CA required + Bachelors of Science, Nursing (BSN) degree required + Five or more years...(BSN) degree required + Five or more years of utilization management required + Four or more… 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...+ Current MA RN Licensure required; Bachelor's degree in nursing , health care administration or related field preferred or… more
- Centene Corporation (New York, NY)
- …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...standards **Education/Experience:** Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 5+ years of related… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and...Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred… more
- Prime Healthcare (Sherman Oaks, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization - management ... degree in a related field. At least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of… 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, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...goals. **Requirements** + BSN is required. Master's Degree in nursing or related field preferred. + 5 years recent… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...and obtains observation status as appropriate. Partners with physicians, nursing , and other care providers to help ensure timely… more
- John Muir Health (Walnut Creek, CA)
- …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
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies...nurse (RN) license with the State Board of Nursing and/or possess multistate licensure if in a … more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5)...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Cedars-Sinai (Los Angeles, CA)
- …has named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & ... Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager ... Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...clinical nursing experience required + Experience in utilization review, case management , or discharge planning… more
- Community Health Systems (Bentonville, AR)
- …live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under ... the supervision of a Registered Nurse or physician. This role involves reviewing medical records...clinical nursing experience required + Experience in utilization review, case management , or discharge planning… more
- Cedars-Sinai (Los Angeles, CA)
- …necessity reviews with accepted criteria required **Req ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 ... required + At least 3 of years of ED nursing experience preferred + Emergency Department Case Manager...Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
Related Job Searches:
Management,
Manager,
Manager Utilization Management,
Nursing,
Utilization,
Utilization Management,
Utilization Management Nursing,
Utilization Manager