Utilization Management Jobs in USA

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...

Field Reimbursement Manager - Dermatology (Cleveland/Akron OH) The Reimbursement Business Manager (RBM) is a critical front-line member of the Regeneron Commercial and Field Reimbursement Management team. We are seeking someone to support HCP offices in acquiring appropriate access to Regeneron prod...

Field Reimbursement Manager - Dermatology (Cleveland/Akron OH) The Reimbursement Business Manager (RBM) is a critical front-line member of the Regeneron Commercial and Field Reimbursement Management team. We are seeking someone to support HCP offices in acquiring appropriate access to Regeneron prod...

The Clinical Care Manager is responsible for care coordination for members identified in integrated care physical health and community based settings who would benefit from connection to various mental health substance use and social determinants of health (SDOH). The Clinical Care Manager must util...

Lets do great things together!About ModaFounded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members compassionate support to our commu...

SummaryThe Department of Community and Human Services values diverse perspectives and life experiences. The Department encourages people of all backgrounds to apply including Black Indigenous and People of Color immigrants refugees women LGBTQ people with disabilities veterans and those with lived e...

Department:11200 Navicent Health Medical Center - Case ManagementStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:M-F 8am til 5pm w/ variable holidays/ weekend rotationsPay Range$41.10 - $61.65Major ResponsibilitiesParticipates in rounds on the patient c...

Department:10010 High Point Medical Center - AdministrationStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:N/APay Range$151.65 - $242.65Major Responsibilities:Strategic Planning and Leadership: Participating in strategic planning for the medical center...

Are you passionate about making a difference in peoples lives Do you enjoy working in a service-oriented industry If so this opportunity may be the right fit for you!Modivcare is looking for an experienced Facility Outreach Manager to join our this role you will serve as an advocate within the non-...

**REDUCED Non-Billable Orientation (NBO) Job - 0 Hours NBO vs. Standard 40 NBO** OR WA or CA Pharmacist License Required 3 Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations Audits Appeals ALJ Court hearings etc) **Rare weekends required a few times per year** RE...

**REDUCED Non-Billable Orientation (NBO) Job - 0 Hours NBO vs. Standard 40 NBO** Pharmacy Tech Role **OR PHARM TECH LIC REQUIRED** **MUST have advanced Excel skills. Do not submit without ADVANCED EXCEL. On call 2-3 weekends per year. This position is responsible for performance of technically detai...

AWS Infrastructure Services owns the design planning delivery and operation of all AWS global other words were the people who keep the cloud running. We support all AWS data centers and all of the servers storage networking power and cooling equipment that ensure our customers have continual access...

Provides utilization management functions as a part of the Program for All Inclusive Care for the Elderly benefits management system. This includes providing utilization review and management for all acute post-acute and outpatient services as well as performing the identification analysis and resol...

Hourly Pay Range:$40.45 - $62.70 - The hourly pay rate offered is determined by a candidates expertise and years of experience among other factors.Position Highlights:Position: RN Transitional Care Navigator-Population HealthLocation: Skokie ILFull Time:40 hoursHours: Monday-Friday 8:30a-5:00p; 2 da...

DescriptionPosition SummaryThe Single Case Agreement (SCA) Specialist is responsible for securing reimbursement and coverage for services therapies or medical technologies on a patient-by-patient basis through negotiation with health plans. This role serves as a key liaison between providers payers...

DescriptionROMTechis a medical technology company that has created and patented a revolutionary medical device and telemedical platform which delivers in-home rehabilitative care. Our disruptive technology has proven to yield faster recoveries and better outcomes with unmatched patient compliance. W...

Under the supervision of the Medical Director and Clinical Supervisor provides clinic nursing services including assessing participants participates in the interdisciplinary team and care planning implements care and case management evaluates participant care and medical records and provides clinic...

SYSTEMS BUILDER WANTEDSeeking an Operational Leader to Build the Infrastructure Behind TubeSciences Creative Engine Role: Creative Operations Lead Location: Los Angeles CA (On-site) Compensation: $110150K base performance bonus tied to operational throughput and efficiency gains Reports to: SVP St...

SYSTEMS BUILDER WANTEDSeeking an Operational Leader to Build the Infrastructure Behind TubeSciences Creative Engine Role: Creative Operations Lead Location: Los Angeles CA (On-site) Compensation: $110150K base performance bonus tied to operational throughput and efficiency gains Reports to: Head o...

Major Accounts Sales Executive - Matterport - Seattle WAJob DescriptionCoStar Group is a leading global provider of commercial and residential real estate information analytics and online marketplaces. Included in the S&P 500 Index CoStar Group is on a mission to digitize the worlds real estate empo...