- buyer (New York, NY)
- …in a Psychiatric Hospital Inpatient and/or Outpatient experience with both case and utilization management . One-year HARP experience preferred. Field based Case ... appropriate services and other resources to assist in goal achievement. Conduct Utilization Review for designated Case Management members for some diversionary… more
- Merck & Co. (Rahway, NJ)
- …allocating resources for cross-product delivery and coordinating with investment Manager to ensure appropriate coordination and forecasting.Communicate IT strategy ... requirements to ensure uninterrupted effective delivery.Developing and maintaining resource utilization and capacity planning, including utilizing a standardized cost… more
- Merck & Co. (Durham, NC)
- …several years; currently Durham employs 1,000+ people. This role as a Manager , Operations will be an energetic, leader with strong interpersonal, leadership, and ... finances, labor, employee, environment and safetyTactical and strategic Shift(s) management , including collaboration with indirect staff;Promote the behaviors and… more
- Appcast (San Diego, CA)
- …time management , and communication skillsFamiliarity with DSM-V and utilization management proceduresAbility to analyze utilization issues ... and may be hybrid or fully remote based on performance.The Care Manager will monitor inpatient and/or outpatient mental health and substance abuse services to… more
- Rising Medical Solutions (Los Angeles, CA)
- …preferred provider selections and ensuring compliance with best practices in workers compensation management . We are searching for a case manager with a proven ... one of the following specialties: industrial rehabilitation nursing, medical case management , occupational health, orthopedics, home health care, utilization … more
- UnitedHealth Group (Lacey, WA)
- …(as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management , review referral requests that cannot be approved for ... up to date information to the H&C Transitions Sr. Manager or Medical Director Assure appropriate referrals are made...current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines,… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …ideally be within 25 miles of Murfreesboro, Tennessee. Job Responsibilities Supporting utilization management functions for more complex and non-routine cases as ... The Behavioral Health Case Manager for Transitions of Care is dedicated to...effective care linkage, patient education, and reducing readmissions. This hybrid position involves telephonic outreach and weekly visits to… more
- Guardian Life Insurance Company (Holmdel, NJ)
- …through critical incidents, driving root cause resolution, and implementing effective change management practices Dynamic Manager of Major Incident, Problem, and ... Overview: Guardian Life is looking for a dynamic Manager of Major Incident, Problem, and Change &... of Major Incident, Problem, and Change & Release Management to join our team! You Are: Seasoned ITSM… more
- Beth Israel Lahey Health (Boston, MA)
- …by hospital needs. Specialists provide comprehensive clinical and distributive medication management services and will utilize their advanced clinical skills in the ... development of drug use evaluations, ADR reporting, clinic development and management , and creation of business plans Under protocol, initiates, adjusts, monitors,… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …difference, join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and ... experience. 1+ years of managed care experience (eg case management , utilization management and/or auditing...Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite… more
- New York Life Insurance Co (West Mifflin, PA)
- Location Designation: Hybrid - 1 day per month Group Benefit Solutions deliverscomprehensive insurance and absence management solutions for mid-sized and large ... here to learn more about Group Benefits solutions. Locations: Hybrid /Remote - United States Role Overview: The Claim Review...and optimize the Claim Review program. The Claim Review Manager role will lead a team comprised of Claim… more
- MTM, Inc. (Middleton, WI)
- …Provide ongoing support to transportation providers regarding claims, payments, eligibility, utilization management or any other questions impacting provider ... What will your job look like? The Vendor Account Manager has ultimate responsibility for delivering a high level...reside in the state of Wisconsin. Will be a hybrid role if you reside within 40 miles of… more
- Snorkel AI (Redwood City, CA)
- …to help us redefine how AI is built? Apply to be the newest Snorkeler! Senior IT Manager Hybrid / San Francisco, CA or Redwood City, CA We are looking for a ... Senior Manager of IT to lead and scale our IT...technology, automation, and process improvements. IT Operations & Infrastructure Management : Oversee the design, implementation, and maintenance of scalable… more
- Protiviti, Inc. (Boston, MA)
- …inefficiencies, and opportunities for improvement in areas such as asset utilization , throughput, productivity, quality, and waste management . Collaborating with ... JOB REQUISITION Business Performance Improvement (Manufacturing Process Improvement) Manager LOCATION BOSTON ADDITIONAL LOCATION(S) SAN FRANCISCO, SEATTLE JOB… more
- Real Chemistry (New York, NY)
- …But we can't do it alone - you in? Real Chemistry is looking for a Senior Manager Client Finance to join our growing team! We are looking for a Senior Manager ... of clients. This key role partners with business leads, Account Management , Legal, Resource and other departments, assisting in revenue forecasting, reporting,… more
- Dar Group (Chicago, IL)
- …solutions. Job Summary TYLin's Americas Aviation Sector is seeking a Senior Project Manager for the Central US Area. This position will be based in Chicago ... day-to-day operations of the Sector/Area with focus on performance optimization, and management of projects and project teams. Technical, Project and Quality … more
- SCAN (Long Beach, CA)
- …Job As a member of SCAN Health Plan's Creative Team, the Creative Operations Manager will lead day-to-day project management , intake, and operations for SCAN's ... and efficient delivery-while also unlocking insightful analytics around resource utilization , team bandwidth, production volume, and project flow. Lead weekly… more
- Elevance Health (Las Vegas, NV)
- …for this position. Prior managed care experience required. Previous experience in case management / utilization management with a broad range of experience ... Anticipated End Date: 2025-08-01 Position Title: Behavioral Health Care Manager II - Nevada Job Description: Position specific details: The successful candidate will… more
- Bertelsmann (Morrisville, NC)
- …plans that align with and drive the overall business objectives. Marketing Tool Management - utilization of a wide range of relevant marketing enablement ... for a high energy, strategic, and fast-paced position as a Product Marketing Manager ? Join Relias, the company changing lives throughout the world by helping… more
- CareOregon (Portland, OR)
- …effective systems to ensure access, program integrity, quality of clinical care, utilization management , compliance with OARs and other regulatory standards, ... system or managed care organization Experience in Medicaid, quality assurance, utilization review, case management , and/or risk adjustment Experience with… more
