Full-Time Utilization Management jobs

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WOUND CARE CERTIFIED HOME HEALTH UTILIZATION MANAGEMENT NURSING, RN

Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.Use your skills to make an impact Typically requires Bachelors degree or e...

CompanyCenterwell Home Health
AddressTampa, FL
CategoryInformation Technology
Salary$69,800 - $78,700 per year
Job typeFull-time, Part-time
Date Posted 23 hours ago See detail

Wound Care Certified Home Health Utilization Management Nursing, RN New

Centerwell Home Health

Tampa, FL

$69,800 - $78,700 per year

Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.Use your skills to make an impact Typically requires Bachelors degree or e...

Utilization Management Clinician - Behavioral Health

Pacificsource Health Plans

Springfield, OR

$88K - $111K a year

Collect and assess member information pertinent to members history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services. Coordinate necessary resources t...

Utilization Management Coord- Full- Time

Augusta University Medical Center

Augusta, GA

$78.1K - $98.9K a year

Utilization Management Coord- Full- TimeWork Location: Req Number: 34297Department Name: CARE FacilitationShift: DayPosition Status: Full TimeEmployment Status: RegularThis button is used to apply to this position only.If you are...

Staff Utilization Management Pharmacist (Contract)

York State Department Of Labor

New York, NY

Bachelor's degree/Pharm.D. Must have an active license with the Board of Pharmacy in the state of residence. Pharmacy degree from an accredited college of pharmacy. Ability to participate in Federal prescription programs (Medicare...

Utilization Management Nurse 2 -Post Acute Pre Auth WEEKENDS

Humana

Louisiana, United States

$69.9K - $88.5K a year

Licensed Registered Nurse (RN) in the state of Florida, or compact license, with no disciplinary action. Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting Comprehensive knowledge of...

Utilization Management Nurse Consultant

Cvs Health

Bismarck, ND

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...

Utilization Managed Care Nurse

Access Healthcare Physicians, Llc

Spring Hill, FL

From $65,000 a year

401(k). Dental insurance. Health insurance. Life insurance. Paid time off. Vision insurance. 8 hour shift. Day shift. Monday to Friday. Medical records: 1 year (Preferred). CTST: 1 year (Required). RN: 5 years (Required). HEALTH P...

Utilization Management Assoc / Clinical Resource Management

Hartford Healthcare Corp.

Wethersfield, CT

$43.3K - $54.9K a year

Monitorsand manages assigned Utilization Management reports, including the Payer End ofDay report, Utilization Management list, Discharge Log, and the DischargeDisposition report for payers.. Monitorsand manages assigned EPIC work...

Utilization Management Specialist

Kaizen Clinical Partners, Inc.

McAllen, TX

$44.9K - $56.8K a year

Analyze electronic medical records. Focus on evaluating the utilization of healthcare services, treatments, and procedures. Utilize retrospective reviews and other UM tools to identify opportunities for improvement and optimize pa...

Utilization Management Specialist

Group Health Cooperative Of Eau Claire

Altoona, WI

$41.5K - $52.5K a year

Applies clinical experience, health plan benefit structure, health management policies and procedures, and claims payment knowledge to authorization reviews. Leverages clinical knowledge, business rules, regulatory guidelines and...

Utilization Management Nurse Consultant

Cvs Health

Harrisburg, PA

$29.10 - $62.31 an hour

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

utilization & case management educator (rn) - Baltimore, United States - LifeBridge Health

Lifebridge Health

United States

Description UTILIZATION & CASE MANAGEMENT EDUCATOR (RN)Baltimore, MDSINAI HOSPITALCARE MANAGEMENTFull-time - Day shift - 8:00am-4:30pmRN Other82791Posted:April 29, 2024Apply Now// Setting the Saved Jobs linkfunction setsavedjobs(e...

Utilization Management Supervisor Non Clinical

Adventhealth Tampa

Tampa, FL

$24.60 - $36.90 an hour

Paid Days Off from Day One. Student Loan Repayment Program. Career Development. Whole Person Wellbeing Resources. Mental Health Resources and Support. AdventHealth Pepin Heart Institute, known across the country for its advances i...

Utilization Management Clinician- Behavioral Health

Cvs Health

Austin, TX

3+ years post degree experience in a psychiatric or substance abuse setting required. -3 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...