Full-Time Utilization Management jobs
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UTILIZATION MANAGEMENT NURSE CONSULTANT
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...
| Company | Cvs Health |
|---|---|
| Address | Hartford, CT |
| Category | Accounting/Finance |
| Date Posted | 2 days ago See detail |
Utilization Management Nurse Consultant
Cvs Health
Hartford, CT
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...
2 days ago seen See more...
- View all Cvs Health jobs - jobs in Hartford, CT
Utilization Management Clinician, Behavioral Health
Cvs Health
Sacramento, CA
Gives providers determinations/recommendations along the continuum of care facilitates including effective discharge planning.- Coordinate with providers and other parties to facilitate optimal care/treatment.- Identify members at...
4 days ago seen See more...
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Utilization Management Nurse Consultant
Cvs Health
Springfield, IL
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...
5 days ago seen See more...
- View all Cvs Health jobs - jobs in Springfield, IL
Utilization Management Assoc / Clinical Resource Management
Hartford Healthcare
Wethersfield, CT
Monitors and manages assigned Utilization Management reports, including the Payer End of Day report, Utilization Management list, Discharge Log, and the Discharge Disposition report for payers. Monitors and manages assigned EPIC w...
5 days ago seen See more...
- View all Hartford Healthcare jobs - jobs in Wethersfield, CT
Utilization Management Nurse - Dallas, TX
Adecco
Dallas, TX
$ 80000 - $ 90000 / Year
Five years inpatient clinical nursing experience in an acute care hospital setting required.. Minimum of two years Utilization Management acute care setting experience required. . Minimum of one-year drafting and submitting reco...
a week ago seen See more...
- View all Adecco jobs - jobs in Dallas, TX
Utilization Management Nurse Consultant
Cvs Health
Columbus, OH
Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. We are health care innovators.Fundamentals:Through the use of cli...
2 weeks ago seen See more...
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Utilization Management & Review Specialist
Med-Metrix
Parsippany, NJ
Serve as point of contact for client operational staff members impacted by UM/UR Processes. Track and monitor solutions implemented for clients and operational staff. Identifies system needs to support short and long term product...
2 weeks ago seen See more...
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Nurse IV (Utilization Management)
Department Of Veterans Affairs
Vancouver, WA
Competitive
U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...
2 weeks ago seen See more...
Behavioral Health Utilization Management, Remote - Kansas License
Unitedhealth Group
Overland Park, KS
Manage facility-based admissions for mental health and substance abuse through the continuum of care. Effectively collaborate with treating providers and facilities to ensure consumers are receiving treatment in line with best pra...
2 weeks ago seen See more...
- View all Unitedhealth Group jobs - jobs in Overland Park, KS
Texas Institute Utilization Management Nurse -Dallas
Adecco
Dallas, TX
$ 80000 - $ 90000 / Year
Five years inpatient clinical nursing experience in an acute care hospital setting required. Minimum of two years Utilization Management acute care setting experience required. Minimum of one year drafting an...
2 weeks ago seen See more...
- View all Adecco jobs - jobs in Dallas, TX
Utilization Management Clinical Nurse Consultant
Cvs Health
Phoenix, AZ
3+ years clinical practice experience required.. Must have a active and unrestricted RN Licensure in the state of Arizona or Compact RN licensure. Utilization management experience preferred.. Acute care setting experience preferr...
2 weeks ago seen See more...
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Utilization Management Nurse Consultant
Cvs Health
Phoenix, AZ
1+ year varied Utilization Management experience within an inpatient/Outpatient setting, concurrent review or prior authorization. 5+ years of variety clinical experience required including acute care, home health, or long term ca...
2 weeks ago seen See more...
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Supervisor, Utilization Management
Altais
Oakland, CA
Supervises and coordinates activities of utilization review staff in maintenance of informed policy and procedure manuals, files, records and correspondence. Provide guidance on issues related to referral and authorization process...
2 weeks ago seen See more...
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RN Supervisor Utilization Management
Dignity Health Medical Foundation
Rancho Cordova, CA
Under general supervision this position is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to ensure requests are processed in a consistent and timely manner while observing regulatory g...
2 weeks ago seen See more...
System Solutions Analyst I (Utilization Management)
Hawaii Medical Service Association
Honolulu, HI
Bachelor's degree and one year of related work experience; or equivalent combination of education and related work experience. Good verbal communication skills to present information before groups, departments, and management. Goo...
2 weeks ago seen See more...
Director Utilization Management
Commonspirit Health
Rancho Cordova, CA
Current California RN license. Bachelor's degree in Nursing, Health Care Administration or advanced clinical degree. Minimum of three (3) years clinical case management (Utilization Management, denial management, care coordination...
2 weeks ago seen See more...
Medical Director, Utilization Management
P3 Health Partners
Henderson, NV
This role will provide medical leadership in clinical initiatives aimed at improving patient services, quality and safety outcomes, physician alignment and satisfaction, and implementing evidence-based programs, practices, and act...
2 weeks ago seen See more...
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Utilization Management RN - Remote
Mitchell Martin
New York, NY
Our client located in New York, NY is looking for an Utilization Management RNType: ContractSchedule: M-F 8a-5p Location: RemoteThe Registered Nurse will perform clinical and operational processes related to transition / coordinat...
3 weeks ago seen See more...
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Clinical Utilization Manager
Embrace Families
Orlando, FL
Monitor and supervise Behavior Health Coordinators specific to the oversight of licensed out of home care and ensuring appropriate levels of care for children. Oversee higher levels of care and ensure suitability procedure is foll...
3 weeks ago seen See more...
- View all Embrace Families jobs - jobs in Orlando, FL
Utilization Management Clinical Consultant
Cvs Health
Louisiana, United States
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care a...
3 weeks ago seen See more...
- View all Cvs Health jobs - jobs in Louisiana State
Customer Success Utilization Manager - MN/WI
Karl Storz Endoscopy - America
Los Angeles, CA
$67,600 - $107,800 per year
Consult with customers to create a customized strategy that ensures customers understand, utilize, and leverage products purchased and bringing to life the VALUE of their installation. Custom design, plan and execute on plans for...
3 weeks ago seen See more...
Registered Nurse (RN), Utilization Management - Adolescent Psych - PRN - Now Hiring
Denver Health
Denver, CO
$34.45 - $51.68 per hour
Works closely with other DHHA staff members including providers, nursing, insurance personnel, scheduling staff, staff in other departments.. (20%). Participates in care planning and discharge planning with the staff, providers an...
3 weeks ago seen See more...
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RN Case Manager I Utilization Review PRN Days
Birmingham Market Office
Dolomite, AL
This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention Transition Management promoting appropriate length of stay,...
7 days ago seen See more...
Utilization Management Coordinator
Sanford Health
United States
We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Monday - Friday 8:30 am to 4 pm...
4 weeks ago seen See more...
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Laboratory Utilization Management and Process Improvement Specialist
Labcorp
Portland, OR
$83K - $105K a year
Uses knowledge of Medical Laboratory Science in combination with IT skills to support customers in working through application to produce meaningful reports and data sets. Demonstrates knowledge of laboratory processes from the pr...
4 weeks ago seen See more...
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Director - Utilization Management
San Jose Behavioral Health
San Jose, CA
Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. . Conducts and oversees concurrent and retrospective reviews for all patients....
4 weeks ago seen See more...
RN or LPN Utilization Management PST - Remote
Unitedhealth Group
Washington, United States
Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Perform all function...
4 weeks ago seen See more...
- View all Unitedhealth Group jobs - jobs in Washington State
Behavioral Health Care Advocate - Utilization Management - Remote in Missouri
Unitedhealth Group
Springfield, MO
Perform Utilization Management, utilization review, or concurrent review of Behavioral Health admissions and continued stay. Determine appropriateness of inpatient and outpatient services following evaluation of designated guideli...
a month ago seen See more...
- View all Unitedhealth Group jobs - jobs in Springfield, MO
Onsite/Remote- Sr Utilization Management Nurse RN Onsite or Remote
Optum
Boston, MA
$90.6K - $115K a year
Audit entire medical record for accuracy of the coding on the MMQ to support payment to the nursing facility. Answer patient questions regarding care (medication, treatment) and benefits. Discuss Patient Care specifics with peers...
a month ago seen See more...
- View all Optum jobs - jobs in Boston, MA
Utilization Management Nurse Consultant
Cvs Health
Trenton, NJ
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...
a month ago seen See more...
- View all Cvs Health jobs - jobs in Trenton, NJ
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