Utilization Manager jobs
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UTILIZATION MANAGEMENT COORDINATOR
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...
| Company | Sanford Health |
|---|---|
| Address | United States |
| Category | Information Technology |
| Job type | Full-time |
| Date Posted | 4 days ago See detail |
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 days ago seen See more...
- View all Sanford Health jobs
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...
5 days ago seen See more...
- View all Labcorp jobs - jobs in Portland, OR
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....
6 days 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...
6 days ago seen See more...
- View all Unitedhealth Group jobs - jobs in Washington State
Case Manager Utilization RN-Per Diem New
Kaiser Permanente
Ventura, CA
Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of app...
19 hours ago seen See more...
- View all Kaiser Permanente jobs - jobs in Ventura, CA
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 week 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 week 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 week ago seen See more...
- View all Cvs Health jobs - jobs in Trenton, NJ
Utilization Management Clinical Processor
Avesis, Incorporated
Remote
$18.33 - $28.67 an hour
- determining cases of recommended treatment in accordance with Avesis UM procedural guidelines or refers the case to Clinical Director or consultant for professional review of clinical denials. Understands and upholds Avesis pol...
a week ago seen See more...
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Supervisor of Utilization Management- Non Clinical
Villagecare Of New York
Remote
$68,000 - $76,000 a year
Monitors that all authorizations are completed accurately, efficiently, and timely. Provides support to Case Management and Care Coordinator team in tracking, authorizing, and delivering service requests. Oversees the productivity...
a week ago seen See more...
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Vice President of Utilization Management
Consilium Partners360, Llc
Remote
$200,000 - $230,000 a year
8 years of management experience in a health-related field. 10 years of experience in a Utilization Management position. Hospital based clinical experience required. Experience analyzing and using data to drive improvement activit...
a week ago seen See more...
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Utilization Management Administrative Support Coordinator
Humana
Louisiana, United States
$40.9K - $51.7K a year
Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prio...
a week ago seen See more...
- View all Humana jobs - jobs in Louisiana State
Associate Director, Utilization Management Nursing - VA Medicaid
Humana
Virginia, United States
$102,200 - $128,000 a year
Serves as a liaison between Humana and the Commonwealth regarding prior authorization reviews, prepayment retrospective reviews, and any additional Utilization Management functions. Coordinates with the Clinical Leadership team to...
a week ago seen See more...
- View all Humana jobs - jobs in Virginia State
Utilization Management Reviewer I
Crawford & Company
United States
$75.3K - $95.3K a year
Uses clinical RN or RPT training and knowledge to render authorization decisions of medical necessity of requested medical treatment. Analyzes medical information and applies clinical knowledge and established criterion to facilit...
a week ago seen See more...
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Utilization Management Representative
Elevance Health
CHICAGO, IL
Managing incoming calls or incoming post services claims work. . Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requ...
a week ago seen See more...
- View all Elevance Health jobs - jobs in CHICAGO, IL
Utilization Management Nurse
One Senior Care
Erie, PA
9 Paid Holidays. 3 Weeks and 1 Day of Paid Time Off Accrued from the Date of Hire for Full-Time Employees. Annual Pay increases for Performance. Medical, Dental, & Vision. Free Life and AD&D Insurance Plan. Health Savings and Flex...
a week ago seen See more...
- View all One Senior Care jobs - jobs in Erie, PA
Registered Nurse (RN) - Utilization Management (Remote)
Uva Health
Charlottesville, VA
$71,988.80 - $115,190.40 a year
They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. All Utilization Management activities are performed in accordance with the mission vision and values of UVA...
a week ago seen See more...
- View all Uva Health jobs - jobs in Charlottesville, VA
Utilization Management LVN Nurse - Remote
Conifer Value
Frisco, TX
$27.30 - $40.95 an hour
Responsible for providing timely referral determination by accurate:Usage of the Milliman Care Guidelines.Identification of referrals to the medical director for review.Appropriate letter language (i.e. denials).Appropriate sele...
2 weeks ago seen See more...
- View all Conifer Value jobs - jobs in Frisco, TX
Utilization Management Registered Nurse
Wexford Health
Sylvania, PA
Work with patients and providers for the patients best interests by helping to ensure appropriate care and maximizing clients medical benefits; Review clinical information provided by the Hospital Utilization Management Departm...
2 weeks ago seen See more...
- View all Wexford Health jobs - jobs in Sylvania, PA
Utilization Management Representative I
Elevance Health
Norfolk, VA
$14.97 - $26.94 an hour
Job Family: CUS > Care Support Type: Full time. Date Posted: Mar 29, 2024 Anticipated End Date: Apr 12, 2024 Reference: JR110000. Managing incoming calls or incoming post services claims work. Determines contract and benefit eligi...
2 weeks ago seen See more...
- View all Elevance Health jobs - jobs in Norfolk, VA
Utilization Management Clinician - Behavioral Health
Pacificsource Health Plans
Salem, 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...
2 weeks ago seen See more...
- View all Pacificsource Health Plans jobs - jobs in Salem, OR
Utilization Management Nurse
Solis Health Plans
Miami, FL
Conduct concurrent and retrospective utilization review for inpatient, observation or SNF services. Conducts clinical reviews of proposed services against appropriate criteria/guidelines to determine medical necessity, benefit eli...
2 weeks ago seen See more...
- View all Solis Health Plans jobs - jobs in Miami, FL
Behavioral Health Utilization Management Coord, PRN
Piedmont Healthcare
Macon, GA
JOB PURPOSE:The purpose of this position is to ensure that admitted patients have the appropriate level of care,patient status, authorization status, plan of care and meet medical necessity for the Behavioral Healthservices. Thi...
2 weeks ago seen See more...
- View all Piedmont Healthcare jobs - jobs in Macon, GA
Utilization Management Representative III
Elevance Health
NORFOLK, VA
Responsible for providing technical guidance to UM Reps who handle correspondence and assist callers with issues concerning contract and benefit eligibility for requested continuing pre-certification and prior authorization of inp...
2 weeks ago seen See more...
- View all Elevance Health jobs - jobs in NORFOLK, VA
Utilization Management Representative III
Elevance Health
NORFOLK, VA
Responsible for providing technical guidance to UM Reps who handle correspondence and assist callers with issues concerning contract and benefit eligibility for requested continuing pre-certification and prior authorization of inp...
2 weeks ago seen See more...
- View all Elevance Health jobs - jobs in NORFOLK, VA
Utilization Management Representative II
Elevance Health
PALO ALTO, CA
Managing incoming calls or incoming post services claims work. . Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requ...
2 weeks ago seen See more...
- View all Elevance Health jobs - jobs in PALO ALTO, CA
RN Utilization Management Nurse - Remote in OR
Unitedhealth Group
Portland, OR
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...
2 weeks ago seen See more...
- View all Unitedhealth Group jobs - jobs in Portland, OR
RN Supervisor Utilization Management
Commonspirit Health
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...
Care Coordinator - Utilization Management
Villagecare Of New York
New York, NY
$25.01 - $28.14 an hour
Respond to inquiries from members and providers regarding health insurance, benefits, eligibility and authorization. Initiate contact with care management team, provider relations department and external providers to meet member's...
2 weeks ago seen See more...
- View all Villagecare Of New York jobs - jobs in New York, NY
Utilization Management Representative I
Elevance Health
NORFOLK, VA
Managing incoming calls or incoming post services claims work. . Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requ...
2 weeks ago seen See more...
- View all Elevance Health jobs - jobs in NORFOLK, VA
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