- AmerisourceBergen Services Corporation (Conshohocken, PA)
- …as month end, ad hoc, rebate, and administration reports; requires the utilization of multiple systems and the consolidation of data from various sources.Excellent ... independent judgment and provide insight and recommendations to upper level management .Ability to read and interpret complex contractual agreements in regards to… more
- CHRISTUS Health (Lake Charles, LA)
- …for effective supervision of nursing activities of assigned area(s). Assists management of financial and human resources to ensure services meet established ... and addressing staff training and development needs. Standard I. Human Resources Management Evaluates and specifies the critical resources required to accomplish the… more
- AmerisourceBergen Drug Corporation (Conshohocken, PA)
- …with 400+ pharmaceutical manufacturing partners, enterprise IT, category management , regulatory assurance, and other various cross-functional teamsEstablish and ... internally and externallyProficiency in Microsoft Word, PowerPoint and ExcelProject management experienceLean or Six Sigma Certified preferredExperience in product… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic direction,… more
- Catholic Health Initiatives (Lexington, KY)
- …both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination model. The … more
- Sharp HealthCare (San Diego, CA)
- …the episode of care and supports other members of the System Centralized Utilization Management team to ensure final status reconciliation. This position ensures ... Qualifications** + Bachelor's Degree in a health related field. + 3 Years Utilization Management or case management within a hospital or payer setting. +… more
- Centene Corporation (Atlanta, GA)
- …Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- CareFirst (Baltimore, MD)
- …based on business needs and work activities/deliverables that week. The Director, Utilization Management provides strategic leadership of the utilization ... and is responsible for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director, Utilization Management is responsible for directing, leading, and ... the business processes and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient & Outpatient)… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 Your career starts now. We are ... Chief Medical Officer for the Ohio Market, this position is representing Utilization Management (UM) in state interactions/audits, validation of regulatory… more
- Fairview Health Services (St. Paul, MN)
- **Overview** M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides comprehensive assessment, planning, ... coordination, implementation, and reporting of complex clinical data. The Utilization Management Specialist is responsible for the completion of admissions and… more
- CVS Health (Tallahassee, FL)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and work schedule may ... state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- Hackensack Meridian Health (Hackensack, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of the… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …The Jesse Brown VA Medical Center has a full-time Registered Nurse - Utilization Management position available for current, permanent employees of the Jesse ... Brown VA Medical Center and it's CBOC's. Utilization Management refers to an overall program aimed at increasing the efficiency and appropriateness with which… more
- Hackensack Meridian Health (Neptune, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- Hackensack Meridian Health (Holmdel, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- Hackensack Meridian Health (Hackensack, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- The Cigna Group (Franklin, TN)
- The Chief Medical Officer (CMO) Utilization Management will develop and manage efforts to improve and maintain cost and utilization trends. Responsible for ... departments of insurance, and similar accreditors/regulators for the performance of all utilization management (UM) programs across the enterprise. The CMO is… more
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