- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- Elevance Health (Tampa, FL)
- …is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management ** is responsible for managing a team of ... physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 30, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review,… 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 ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... hospital inpatient admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined criteria. b.… more
- Actalent (Duluth, GA)
- …Description Nurse will be working on site. Responsibilities will include: Case Manager / Utilization Management (90%) and Discharge Planning. Develop ... Case management & Utilization management ...Oregon. Required Skills At least 1 year of case management /care management Must be a RN (Registered… more
- Access Dubuque (Dubuque, IA)
- … and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management Nurse Cottingham & Butler/ SISCO CNA Psychiatric Unit ... Utilization Management CNA **Cottingham & Butler/ SISCO** 1 Positions ID: 4965537008 Posted On 10/24/2025 Refreshed On 11/24/2025 **Job Overview** **… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable hospital days and communicates… more
- Community Health Systems (Bentonville, AR)
- …live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under ... services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable hospital days and communicates… more
- Corewell Health (Grand Rapids, MI)
- …required Or + Basic Life Support (BLS) - ARC American Red Cross Ambulatory Care Management Upon Hire required + Case Manager , Certified (CCM) - CCMC Commission ... prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals and population of… more
- Billings Clinic (Billings, MT)
- …issues, escalates to Supervisor, Manager , or Director * Insurance and Utilization Management * Maintains working knowledge of CMS requirements and ... care manager staff provide services consisting of comprehensive case management , care coordination, continuing care services, and clinical social work services… more
- Access Dubuque (Dubuque, IA)
- …UnityPoint Health Finley Hospital Account Manager Cottingham & Butler/ SISCO Utilization Management Nurse Cottingham & Butler/ SISCO Neonatal - Nurse ... Hospice Nurse Case Manager **Hospice of Dubuque** 1 Positions ID: 84480...of each patient's plan of care, + performs case management and direct patient care, and + participates in… more
- AmeriHealth Caritas (Philadelphia, PA)
- …us at www.amerihealthcaritas.com . **Responsibilities:** Under the supervision of the LTSS Manager /Director for Utilization Management , this position is ... Home Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical and operational… more
- Amergis (Orange, CA)
- …Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and ... as those listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care experience. + Behavioral… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …preferred, ie, Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), Certified Professional Utilization Management (CPUM), ... administration, or nursing. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + A minimum of five years of experience in… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
- Trinity Health (Berwyn, IL)
- …are currently looking for an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general ... supervision, manages Utilization resources and quality of healthcare services through performing initial intake, support and processing of pre-certification requests for eligible members received via portal, EHR, or telephonic, for outpatient and inpatient… more
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