Utilization Management Jobs in USA

OverviewThis posting is open exclusively to current AL DOC incumbent employees.NaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Alabama Department of Corrections - Childersburg in Childersburg AL.As a Correctional AA you will work alongside correct...

OverviewThis posting is open exclusively to current AL DOC incumbent employees.NaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Alabama Department of Corrections - St. Clair in Springville AL.As a Correctional AA you will work alongside correctiona...

OverviewYour job is secure. This process simply allows us to enter your information into NaphCares payroll system quickly and accurately. After your submission you will receive a confirmation letter outlining your position and pay details for your to electronically sign. If you have any questions pl...

Psychiatric Mental Health Nurse Practitioner (Crisis / OSC Expedited Care)Community Bridges INCFront end/ Back end; Sunday Tuesday Rotating Wed 7AM-7PM; Rotating Wed Thursday Saturday 7AM-7PMFull Job DescriptionCommunity Bridges Inc. (CBI) is an integrated behavioral healthcare agency offering a v...

Job Title: Licensed Practical Nurse Location (Onsite Remote or Hybrid): Franklin NH (onsite) Contract Duration: 14 weeks Working Hours: 7:00 PM - 7:30 AM Total Weekly Hours: 36 POSITION SUMMARY: Under the direction of a Registered Nurse (RN) the Licensed Practical Nurse delivers efficient...

NOTE: Guidehealth is unable to provide sponsorship of any work visa now or in the future. Thank you.Guidehealth is on a mission to make healthcare affordable for everyone and the Data Science team is at the heart of making that happen. As a Senior Technologist youll build the data pipelines automati...

DescriptionUnder broad direction from the Centralized Utilization Management Manager is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant pediatric adolescent young adult adult and geriatric patients. Incumbent of this position is...

TITLE: Utilization Management Physician (UMP)Location: RemoteEmployment Type: Full-TimePosition SummaryA leading healthcare organization is seeking a Utilization Management Physician (UMP) for a full-time remote role. This position requires strong clinical judgment critical thinking and effective co...

Anticipated End Date:Position Title:Behavioral Health Compliance ManagerJob Description:Behavioral Health Compliance ManagerLocation: This role requires associates to be in-office 1 - 2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and wor...

Anticipated End Date:Position Title:Behavioral Health Compliance ManagerJob Description:Behavioral Health Compliance ManagerLocation: This role requires associates to be in-office 1 - 2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and wor...

DescriptionScheduleFull-Time: 80 Hours/BiweeklyHours: Monday through Friday 10:30-7:00 with weekend rotation.General SummaryPlans organizes and implements social work for patients and families. Works in a team model to address patient care needs.ResponsibilitiesEssential Functions:Assesses patients/...

Employment Status:Full timeShift:Weekends Only (United States of America)Facility:1906 Belleview Ave SE - RoanokeRequisition Number:R152757 Case Management Team Lead - RN - Weekdays (Open) How Youll Help Transform Healthcare:The Case Management Lead RN serves as a team leader clinical resou...

Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria includingAdmission reviewsContinued stay reviewsTransitional care reviews (Skilled Nursing Facility Inpatient Rehabilitation Facility Long-Term Acute Care Hospital)R...

Help protect integrity strengthen compliance and improve how we serve our members.At Liberty Dental Plan our Internal Audit team plays a critical role in ensuring accuracy compliance and operational excellence across our organization. We are looking for a detaildriven analytical Sr. Internal Auditor...

DescriptionHealthPartners is hiring a Provider Relations and Contracts Service Specialist. This position is the key resource to assigned primary care groups specialty care groups hospitals and/or other medical providers (providers) participating with the organizations health plan networks. To maximi...

OverviewExisting YesCare employees working at the Alabama DOC Facilities do not need to apply. You will be contacted directly by a NaphCare representative.NaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Limestone Correctional Facilityin Harvest AL...

DescriptionHealthPartners is hiring a Provider Relations and Contracts Service Specialist. This position is the key resource to assigned primary care groups specialty care groups hospitals and/or other medical providers (providers) participating with the organizations health plan networks. To maximi...

Company :Allegheny Health NetworkJob Description :JOB SUMMARYThis role requires a strong understanding of pharmacy benefits insurance processes and patient access procedures. Responsibilities include the coordination and administration of effective and efficient processing for pharmacy benefits prio...

Job Description SummaryWe are seeking an experienced board-certified MD or DO to serve as Regional Medical Director. The ideal candidate will have demonstrated leadership in value-based care models (ACOs MSSP Medicare Advantage commercial risk arrangements) strong clinical and operational judgment a...

City/StateVirginia Beach VAWork ShiftFirst (Days)Overview:Sentara Health Plans is hiring for a Behavioral Health Utilization Management Care Coordinator- Whole Person Care- Hybrid in the Peninsula Region!Position Status: Full-time permanent (40 hours/week)Standard Working Hours: 8 AM to 5 PM EST M-F...