Utilization Management Jobs in USA

DescriptionTHE POSITIONUnder general direction of the Health Care Plan Administrator responsible for managing the daily operations of the Quality Assurance Utilization Management and Case & Disease Management departments within the Ventura County Health Care Plan.The Director of Health Services - Ve...

DescriptionHealthPartners is hiring an RN Medical Coverage Policy Consultant. The Consultant is responsible for the development maintenance review and implementation of medical policies/criteria which support clinical decision-making coverage for services that are rooted in scientific evidence prove...

Our CompanyAdoration HealthOverviewThe Patient Care Manager Assistant supports the Clinical Manager in coordinating staff to ensure continuity and quality of care for assigned home health patients. Ensures team members are informed skilled and deliver care efficiently in compliance with physician or...

What Awaits You:Opportunities for Career Growth Build a meaningful career with access to professional development mentorship and advancement pathways.Collaborative and Inclusive Environment Work alongside a diverse team of professionals who value mutual respect innovation and teamwork.Comprehensiv...

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:10/40 - 10 Hour ShiftAdditional Shift Information:10 hour shifts between the hours of 7 am and 7 pmWeekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$46.110 - $59.500 - $66.650T...

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:up to 8 hour shifts between the hours of 7 am and 7 pmWeekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$50.720 - $65.450 - $73.3...

OverviewNaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Arizona Department of Corrections - Winslowin Winslow AZ.As a Correctional AA you will work alongside correctional officers and other medical professionals who provide care to the individuals...

About Blue Cross and Blue Shield of MinnesotaAt Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate...

Hours:Shift Start Time:8 AMShift End Time:4:30 PMAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:No WeekendsOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$25.550 - $31.860 - $35.680The stated pay scale reflects the range that Sharp reas...

IntroductionTHIS IS A NEW ASSEMBLED EXAMINATION. The eligible list resulting from thisexamination will cancel any existing list and may last approximately one yearbut can be extended.Applications must bein the possession of the Human Resource Services Department by 5:00:00 p.m. onthe Last Day for Fi...

Position SummaryThe Database Sustainment Specialist (DSS) provides comprehensive sustainment maintenance reconciliation and data integrity support for Bureau of Medicine and Surgery (BUMED) Facility Management databases and related enterprise systems. The DSS is responsible for maintaining facility...

Position SummaryThe Database Sustainment Specialist (DSS) provides comprehensive sustainment maintenance reconciliation and data integrity support for Bureau of Medicine and Surgery (BUMED) Facility Management databases and related enterprise systems. The DSS is responsible for maintaining facility...

As aPre-Auth Consultantyou will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Mandatory skills FACETS UM/Pre-Auth Configuration ITS/Authorization Routing Logic SQL & Rule Traceability Responsibil...

    Conducts training for staff members pertaining to Utilization Review process clinical rules/guidelines client/module/modality-specific workflows and software enhancements     Creates educational material for review tiers by collaborating with key resources across departments to ensure clinical s...

Registered Nurse (RN) Utilization ReviewLocation: Syracuse NYJob Type: 14-Week Contract Traveler or LocalShift: Day Shift (MondayFriday)Hours: 8 Hours Per DayPay Rate: $60 - $65/hourPosition OverviewWe are seeking an experienced Registered Nurse (RN) with Utilization Review and acute care experien...

DescriptionMethodist Hospital is looking to hire a RN Care Manager to join our Care Management team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day.Position Summary:The RN Care Manager provides patient-c...

OverviewHospital Name: Banner Rehabilitation HospitalPartnership with Select MedicalPosition: Case ManagerLocation: Mesa AZSchedule:Per Diem to help cover weekends and PTOCompensation: $45.00 per hourPrevious experience in Case Management and Discharge Planning from a hospital setting or SNF needed....

Inspire health. Serve with compassion. Be the difference.Job SummaryProvides primary health care to a specific patient population within the guidelines of written protocols. Follows established nursing standards procedures and practices.AccountabilitiesEngages in the diagnosis and treatment of dise...

Classification Title:Associate Chief Medical Officer (ACMO) Adult Services UF Health Greater Gainesville MarketClassification Minimum Requirements:M.D. or D.O. degree and board certification in an appropriate clinical specialty.Active medical license and current medical staff membership in good sta...

Position: Director of Case Management Location: Boston Medical Center - South (Brockton MA)Schedule: Full TimePOSITION SUMMARY:The Director of Care Management and Inpatient Social Work Services shall oversee the overall operations of Care Management functions through oversight of both daily and long...