Utilization Management Jobs in USA

Company OverviewKR Wolfe is a nationally recognized leader in technology integration installation and specialty construction services. We support healthcare government education and commercial clientsnationwide with a strong focus on safety compliance and operational excellence. Our people are the f...

Company OverviewKR Wolfe is a nationally recognized leader in technology integration installation and specialty construction services. We support healthcare government education and commercial clients nationwide with a strong focus on safety compliance and operational excellence. Our people are the...

Company OverviewKR Wolfe is a nationally recognized leader in technology integration installation and specialty construction services. We support healthcare government education and commercial clients nationwide with a strong focus on safety compliance and operational excellence. Our people are the...

Company OverviewKR Wolfe is a nationally recognized leader in technology integration installation and specialty construction services. We support healthcare government education and commercial clients nationwide with a strong focus on safety compliance and operational excellence. Our people are the...

Quadelis seeking a Managing Director to provide seniorlevel leadership for the administration of the Housing Choice Voucher Program operating under contract with MiamiDade County Housing and Community Development. This position is intended for an experienced housing leader with a strong record of ma...

Job OverviewDevelop communicate and lead Physical Distribution (Logistics Shipping and applicable Customer Service functions related to delivery) for the Marvin Door business unit located in Windsor CT.Highlights of your roleManage/mentor Driver Dispatch Supervisor.Work with Enterprise Logistics Pro...

Job OverviewDevelop communicate and lead Physical Distribution (Logistics Shipping and applicable Customer Service functions related to delivery) for the Marvin Door business unit located in Windsor CT.Highlights of your roleManage/mentor Driver Dispatch Supervisor.Work with Enterprise Logistics Pro...

Position: Facets UM Consultant with pre-Auth Experience: -10Years Location: -Remote (PST TIME ZONE) Responsibilities: - A Facets UM Consultant is responsible for providing customers with application domain expertise related to Utilization Management rules and processes within the Facets platform....

Job Title: Licensed Practical Nurse Location (Onsite Remote or Hybrid): Albuquerque NM (onsite) Contract Duration: 13 weeks Working Hours: 6:00 PM - 6:30 AM Total Weekly Hours: 36 POSITION SUMMARY: Under the direction of a Registered Nurse (RN) the Licensed Practical Nurse delivers effic...

The Market Access Patient Services (MAPS) organization within APEX plays an instrumental role in shaping market access strategies for all of AbbVies domestic brands. As a member of this team you will plan and execute standard and ad-hoc analytics to identify/ quantify payer opportunities and threats...

This is a remote position with up to 50% domestic travel required. Candidates may reside in the Southwest or Western part of the United States and should expect frequent national travel.The AbbVie Employer NAE is responsible for supporting and implementing strategic business initiatives in response...

Sign on bonus may apply up to $15000 Position Summary: Reviews patient admissions for appropriateness efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts determining whether care provided is within established parameters....

DescriptionThe Registered Nurse (RN) Case Manager works within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management care coordination resource utilization and clinical documentation. The RN Case Manager will...

Anticipated End Date:Position Title:Nurse Appeals -Utilization & Case ManagementJob Description:Nurse Appeals- Licensed NurseLocation: Virtual: This role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy. This a...

OverviewUtilization Management SpecialistFull Time 80 Hours Per Pay Period Day ShiftCovenant Health Overview:Covenant Health is the regions top-performing healthcare network with 10hospitalsoutpatient and specialtyservicesandCovenant Medical Group our areas fastest-growing physician practice divisio...

Scope of Work: Under general direction integrates cost quality and utilization to facilitate the admission continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is to enhance the...

Position: Director of Case Management Acute Care (Leadership Role)Location: Nashville TNCompensation & BenefitsSalary Range: $109762 $135000 (commensurate with experience)Annual Incentive Bonus: Up to 17.5%Sign-On Bonus: $10000Relocation Assistance: Available on a case-by-case basisSchedule: Full-...

OverviewJOB SUMMARY: The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions concurrent stay and readiness for discharge. She/he assures correct level of care: critical telemetry acute observation for all patients. The Case Manager provides an efficient coordinated app...

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

Department OverviewThe Administrative Director of Care Management provides strategic and operational leadership to ensure the provision of high quality safe healthcare and customer service to patients and families in need of Care Management services. The Administrative Director will partner with hos...