- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
- AmeriHealth Caritas (Newtown Square, PA)
- …reviews and/or concurrent reviews in a managed care environment required Experience leading a remote Utilization Management team in a health plan; Licensure ... Role Overview The Utilization Management Review Supervisor manages a remote ...Current and unencumbered Nurse Licensure Compact (NLC) required Ability to obtain RN… more
- Battelle Memorial Institute (Colorado Springs, CO)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- UnitedHealth Group (Omaha, NE)
- …oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers Maintain proficiency in all ... Growing together. We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This...of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.… more
- UnitedHealth Group (Seattle, WA)
- …a difference? Join us to start Caring. Connecting. Growing together As a Registered Nurse Case Manager, Maternal Health you will act in a liaison role with Medicaid ... on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improve quality of care. Interest in learning… more
- Humana (Bloomington, IL)
- …health first Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health ... professionals responsible for care management . The Manager, Care Management , works within...of staff including service performance and adherence to established utilization and care coordination benchmarks. Use your skills to… more
- BlueCross BlueShield of Tennessee (Memphis, TN)
- …as travel is required to meet with members\.** **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as ... **SelectCommunity at BCBST is seeking a Registered Nurse ** who is compassionate about case management...ensure effective implementation of interventions, and to ensure efficient utilization of benefits + Performing the essential activities of… more
- Amgen (Cleveland, OH)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... to support optimal patient care. As a SAM, you will drive product utilization while identifying and addressing the unique needs of each account. This includes… more
- GE Aerospace (Schenectady, NY)
- …within manufacturing lines to achieve Operating goals using KPI-based performance management . Coach and Collaborate with all levels of the organization and ... implementation of Lean principles. Partner, develop and execute standard Capacity Utilization process in partnership with the local Operations, Lean and Industrial… more
- Amgen (San Jose, CA)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... support optimal patient care. As an Account Manager, you will drive product utilization while identifying and addressing the unique needs of each account. This… more
- UnitedHealth Group (Hartford, CT)
- …Preferred Qualifications: Registered Nurse 2+ years of experience in Utilization Management Experience working with federal contracts CES (Claims Editing ... This position is National Remote . You'll enjoy the flexibility to telecommute* from...avoidance development Serves cross-functionally with Medical Directors, and sometimes Utilization Management , as well as other internal… more
- Oracle (Salt Lake City, UT)
- …the Millennium platform. Excellent communication and interpersonal skills for remote collaboration, including virtual presentations and stakeholder management . ... directly with clients at a prominent academic medical center in the Midwest. This remote role will act as the primary subject matter expert and point person for… more
- GE Vernova (Phoenix, AZ)
- …to evaluate alternatives and optimize delivery timelines and resource utilization . Identify schedule risks and opportunities, driving mitigation and recovery ... Government projects. Background in cost control and earned value management (EVMS). Experience in the hydropower industry. Knowledge of...a drug screen (as applicable). Relocation Assistance Provided: No #LI- Remote - This is a remote position… more
- Teleflex (Buffalo, NY)
- …market today, from our world-class brands including: + LMA and Rusch airway management devices designed to help reduce the risk of airway-related complications. + ... Arrow pain management products designed to improve patients' post-operative pain experience. Join a dynamic, growing team that offers healthcare providers advanced… more
- Teleflex (Houston, TX)
- …market today, from our world-class brands including: + LMA and Rusch airway management devices designed to help reduce the risk of airway-related complications. + ... Arrow pain management products designed to improve patients' post-operative pain experience. Join a dynamic, growing team that offers healthcare providers advanced… more
- Battelle Memorial Institute (Columbus, OH)
- …operations and high-quality patient care. **Responsibilities** + Assist with the management and treatment of outpatient behavioral health activities + Under the ... supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health interventions… more
- Actalent (Minnetonka, MN)
- Remote Utilization Management Nurse Job Description As a Utilization Management Nurse for Post Acute care, you will be responsible for ... to assess the medical necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review. + Experience in acute… more
- CVS Health (Columbus, OH)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
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