- Merck & Co. (Rahway, NJ)
- …and a curiosity for applying emerging technology. This is a people manager role and is responsible for managing two legal support professionals.Job responsibilities ... AI, machine learning, predictive coding, etc.) to improve technology utilization and operational efficiencyEvaluate new vendors, suppliers, and solutions to… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …MSAT, Facilities, C&Q, Project Management, and Quality.Work closely with Sr. Manager , Strategic Initiatives to support various strategic initiatives focusing on site ... of site operational models to better understand and assess resource utilization , equipment utilization , change impact, etc.Support assessment of facility… more
- Nevada System of Higher Education (Las Vegas, NV)
- …Vice Chancellor and the department on a wide range of assignments. Review the Vice Chancellor's incoming and outgoing correspondence and signature items. Exercise ... provide suggestions for resolution or resolve independently whenever feasible.Perform initial review of items for the Vice Chancellor's attention and/or signature.… more
- ChenMed (Cincinnati, OH)
- …patient/family and explain nurse practitioner role.Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide ... and in collaboration with other health care professionals. Consults with the manager , physician, and medical director to ensure compliance with guidelines. This… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- …could be longer based on the presenting symptoms. Every day as an Admissions & Utilization Review Manager you will + Supervise overall operations of DCBHC ... can take your career to the next level. **Being an Admissions & Utilization Review (UR) Manager Devereux Children's Behavior Health Center has its… more
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization /appeals management review . + Assist Utilization and Appeals Manager in setting up communications with payors and/ ... as well as all financial metrics associated with front-end review process. + Collects data, prepares analysis, and oversees...and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- … (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=1450MP&R1=&R3=) to join their team! The Utilization Review Behavioral Health Program ... Behavioral Health Program Manager Office/On-Site Recruitment # 251008-1450MP-001 Location Middletown, CT... (UR BHPM) is responsible for oversight of all Utilization Review functions and staff throughout CT… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Hospital-Plymouth** is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ... + CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management** This role is ideal for a… more
- Mount Sinai Health System (New York, NY)
- …+ Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work ... cases, internal process development, and provide education to the team on utilization review -related issues. Responsibilities + Review prior authorization… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... collaboration with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff… more
- Sharp HealthCare (San Diego, CA)
- …be unrestricted. **Essential Functions** + Referral CoordinationEnsures consistent application of the utilization review process for effective utilization of ... a Managed Care setting. + Experience as a case manager or discharge planner interacting with managed care payers....medically necessary and/or not covered benefit and refer to Utilization Review Committee. Ensures that all denials… more
- Dignity Health (Mesa, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...five (5) years of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
