• Utilization Management

    Intermountain Health (Madison, WI)
    **Job Description:** Physician will provide Physician Advisor Utilization Reviewer and Central Appeals Work services. Physician shall engage, ... as an expert and local resource to hospital Case Management Department and Medical Staff on issues relating to... Utilization Review ("UR") Committee and provide Regional Physician Advisor Educators information to be shared… more
    Intermountain Health (01/06/26)
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  • Customer Success Manager - Engagement Manager

    Wolters Kluwer (Madison, WI)
    …efforts, prioritizing efforts and resources for assigned customer portfolio. + **Ongoing Utilization Management ** + Oversee and analyze customer utilization ... Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider… more
    Wolters Kluwer (12/10/25)
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  • Medical Director - Medicaid (Oklahoma)

    CVS Health (Madison, WI)
    …role that primarily supports the Aetna Better Health Plan of Oklahoma. This UM ( Utilization Management ) Medical Director will be a "Work from Home" position ... and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well...at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent… more
    CVS Health (12/19/25)
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  • Dialysis Clinical Manager Registered Nurse - RN

    Fresenius Medical Center (Fitchburg, WI)
    …departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
    Fresenius Medical Center (11/15/25)
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