- Commonwealth Care Alliance (Boston, MA)
- …implementation of successful methods for working with providers. Ensures integration of utilization management functions with network strategy , vendor ... This Role is Important to Us:** The Director of Utilization Management leads and manages all ...and conflict resolution. + Proven ability to influence and lead ; well-developed teambuilding skills, unquestioned integrity, and the experience,… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... Candidate will be responsible for the oversight of the utilization management team. + Responsible for a...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Ascension Health (Nashville, TN)
- …Additionally, you will facilitate cross-functional meetings to drive collaboration and efficiency, lead strategic initiatives in utilization management to ... to join our team! In this pivotal role, you'll lead clinical discussions during Payer JOC meetings, oversee denial...function within the insurance plan. + Ensure integration of utilization management functions with network strategy… more
- Elevance Health (Tampa, FL)
- RN Utilization Management Nurse Sr. (Medicaid-InPatient) JR130851 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is ... Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Elevance Health (Tampa, FL)
- …for people enrolled in Medicaid and/or Medicare programs in Florida. **Manager I Utilization Management ** **Location:** 11430 NW 20th ST, STE 300, Miami, FL ... used for collaboration, community, and connection. The **Manager I Utilization Management ** is responsible for the daily...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative II** **Location:** Within 50 miles or a 1 hr commute of **Miami** or **Tampa** Florida **Hours:** Monday - Friday, 8:30 ... am - 5:30 pm EST The ** Utilization Management Representative II** is responsible for...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Elevance Health (Washington, DC)
- The Utilization Management Nurse is responsible to...creating a culture that is designed to advance our strategy but will also lead to personal ... years acute care clinical experience. + Minimum 1 year Utilization Management experience preferred. For candidates working...of our culture. They are how we achieve our strategy , power our business outcomes and drive our shared… more
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...creating a culture that is designed to advance our strategy but will also lead to personal… more
- Elevance Health (Indianapolis, IN)
- …At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. ... **Title** : Licensed Utilization Review II **Location** : Candidates must reside...medically appropriate, quality, cost effective care throughout the medical management process. + Educates the member about plan benefits… more
- Elevance Health (Louisville, KY)
- …At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. ... The **Licensed Utilization Review I** is responsible for working with...medically appropriate, quality, cost effective care throughout the medical management process. + Educates the member about plan benefits… more
- Bristol Myers Squibb (Princeton, NJ)
- …ensuring contribution to improving impact and business results and performance. The digital strategy lead will drive the continuous evolution of the Intelligent ... and development of various digital use cases across Procurement + Coordinate with SS&P Strategy & Performance lead to prioritize funding for digital / technology… more
- CenterWell (Tallahassee, FL)
- …and coordinating care to reduce acute and post-acute care utilization . The Clinical Strategy and Practice Lead role is hybrid with a requirement to reside in ... of our caring community and help us put health first** Description: The Clinical Strategy and Practice Lead directly supports the Director of Clinical … more
- JPMorgan Chase (Washington, DC)
- …**Assurance Operations** organization is looking to expand its **Cybersecurity Red Team** with a ** Strategy Lead ** position. The Strategy Lead is tasked ... Cyber and Tech Controls line of business, you will lead key efforts to enhance the firm's cybersecurity or...You will utilize your experience in Information Security, people management , written and oral communication, and project management… more
- Bristol Myers Squibb (Madison, NJ)
- …Manager, SOE Portfolio Strategy and Management , reports to the SOE Portfolio Strategy and Management Lead and is based either in Princeton NJ or ... of sub-team plans and deliverables to inform asset risk management strategy , and to translate asset risk...the organization and upon request + Actively listens to lead program management activities while demonstrating strong… more
- TravelCenters of America (Westlake, OH)
- … the development and execution of the company's Workforce Management strategy to ensure effective labor utilization across all profit centers (including ... with the company and shaping TA's future. **Summary** The Senior Manager, Workforce Management Strategy plays a pivotal leadership role in shaping and executing… more
- Arizona Public Service (Phoenix, AZ)
- …and advising on asset purchases or sales, including direct counterparty. + Project Management : Lead special projects from scoping to execution, ensuring that ... Financial Strategy Consultant or Financial Strategy Senior...Senior Analyst, where you will act as an internal management consultant on high-impact, officer-level projects. This role is… more
- Bank of America (Phoenix, AZ)
- Cons Prod Strategy Mgr II - Digital Money Movement - Fraud Strategy Newark, Delaware;Plano, Texas; Richmond, Virginia; New York, New York; Boston, Massachusetts; ... experienced analytical leader to join the digital commerce fraud strategy team. This is an exciting opportunity given the...in place, and will self-create initiatives as needed. + Lead a team of fraud analysts in the identification,… more
- StoneAge, Inc. (Durango, CO)
- …$125,000 - $145,000 per year. ESSENTIAL FUNCTIONS Key Responsibilities: + Build and lead the Product Strategy department, developing a robust structure to align ... development opportunities to ensure individual and collective success in achieving product strategy goals. + Monitor and adjust resource utilization to maximize… more
- Humana (Columbus, OH)
- …identified opportunities. The AVP will lead a multidisciplinary team that blends strategy , policy, clinical and vendor management and will report directly to ... role within Clinical Operations at Humana to define, prioritize and execute on utilization management -focused initiatives to drive appropriate care in order to… more