Utilization Management Jobs in USA

Field Reimbursement Manager Immunology Pulmonology and Gastroenterology (Tallahassee FL - Montgomery AL - Mobile AL) The Field Access & Reimbursement environment for specialty biologics has proven to be highly challenging for HCPs and Patients. Payer Formularies and restrictive Utilization Manageme...

Director of Case ManagementDetroit MI Full-Time $103000 $155000 Healthcare / Hospital AdministrationWe are seeking an experienced Director of Case Management to lead hospital-based case management operations focused on utilization management patient throughput care coordination reimbursement opti...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorshipand leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your caree...

DescriptionThe RN Manager Care Management provides leadership direction and resource management for case managers and social workers in the inpatient and ambulatory settings. The RN Manager effectively resolves utilization review and denial management issues provides leadership in resolving psychoso...

DescriptionAs part the Mount Sinai Pharmacy team and on behalf of Mount Sinai Human Resources partners the Pharmacy Benefits Program Director is responsible to provide service support reporting pricing and/or other performance guarantees while working with multiple internal stakeholders and other ex...

DescriptionAs part the Mount Sinai Pharmacy team and on behalf of Mount Sinai Human Resources partners the Pharmacy Benefits Program Director is responsible to provide service support reporting pricing and/or other performance guarantees while working with multiple internal stakeholders and other ex...

The State Policy & Government Affairs Director will serve as a key member of Regeneron Pharmaceuticals Public Policy & Government Affairs (PP&GA) team responsible for the development and execution of state-level policy strategies that advance the companys mission to ensure patient access to innovati...

Current Employees:If you are a current Staff Faculty or Temporary employee at the University of Miami please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position please review this tip sheet.The University of Miami has a great...

The State Policy & Government Affairs Director will serve as a key member of Regeneron Pharmaceuticals Public Policy & Government Affairs (PP&GA) team responsible for the development and execution of state-level policy strategies that advance the companys mission to ensure patient access to innovati...

OverviewOhio Health Rehabilitation Hospital*A joint venture with Select Medical & Ohio Health*Columbus OhioDirector of Case ManagementResponsibilitiesPosition SummaryThe Director of Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure tre...

Find your calling at Mercy!The Nurse Navigator is a leader providing support mentorship and guidance to those who provide direct patient care. The Nurse Navigator coordinates the delivery of patient care by assessing care requirements of the individual patient and makes recommendations based on seve...

Inspire health. Serve with compassion. Be the difference.Job SummaryProvides assistant surgical services in the operating room as well as other selected medical services under the direction of the surgeon.AccountabilitiesProvides general surgical assistant services in operating room.10%Assists surg...

Job DescriptionGrow your career with Saint Lukes South! We are looking for a driven RN or Social Worker ready to step into a Manager Care Progression role and lead the future of patient care coordination and professional growth! RN LCSW or MSW requiredMasters required for Social WorkerBachelors requ...

Job DescriptionGrow your career with Saint Lukes South! We are looking for a driven RN or Social Worker ready to step into a Manager Care Progression role and lead the future of patient care coordination and professional growth! RN LCSW or MSW requiredMasters required for Social WorkerBachelors requ...

POSITION SUMMARY:The Associate Authorization is a position responsible for ensuring that patient care services are ready to bill accurately and in a timely manner. The primary responsibility of the role is to obtain authorization for care from insurance carriers and provide denial support. This posi...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

JOB SUMMARY:The inpatient medical director specializes in evaluating diagnosing and treating mental emotional and behavioral disorders through medication psychotherapy and other interventions on a geriatric psychiatry unit while providing administrative oversight to manage and improve the psychiatri...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

DescriptionWhy Join UsSign-On Bonus and/or Relocation Reimbursement OfferedCompetitive CompensationComprehensive Medical Dental Vision & Life InsuranceGenerous Paid Time Off & Extended Illness BankMatching 401(k) Retirement PlanOpportunities for Career Grown & AdvancementRecognition & Reward Program...