- CHRISTUS Health (San Antonio, TX)
- …and operations for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Geisinger (Wilkes-Barre, PA)
- … and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 05/01/2025Job ID: ... the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and mentors new… more
- Geisinger (Scranton, PA)
- … and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 05/01/2025Job ID: ... the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and mentors new… more
- Geisinger (Wilkes-Barre, PA)
- … and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 05/09/2025Job ID: ... the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and mentors new… more
- Geisinger (Scranton, PA)
- … and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 05/10/2025Job ID: ... the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and mentors new… more
- Daiichi Sankyo, Inc. (Chesapeake, VA)
- …meet targeted customer needs.Monitor, collect, and communicate to the Director, Clinical Nurse Manager on customer insights regarding their need for information ... Nephrology, and Gastroenterology or relevant experience requiredExperience with anemia management strongly preferred and infusion nursing experience… more
- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... managing the daily operation of the Utilization Management Review Nurse and...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to… more
- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... documentation and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Sep 26, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the...for this role will have a bachelor's degree in nursing , public administration, public policy, public health or related… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Utilization Management ** ** Manager ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing… 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...+ Current MA RN Licensure required; Bachelor's degree in nursing , health care administration or related field preferred or… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... field or at least one year experience in case management , discharge planning or nursing management...5 years of acute care experience preferred.2. Certified Case Manager (CCM) certification preferred.3. At least one-year experience in… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... degree in a related field. At least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of… more
- Prime Healthcare (Chino, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226811/case- manager -%28rn%29 utilization - ... years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse ...experience preferred. At least one year experience in case management , discharge planning or nursing management… more
- Actalent (Santa Barbara, CA)
- …unit, such as Mental/Behavioral Health services. Skills: Care plans, Case Manager , Pediatrics, Utilization Management , Clinical Reviews Experience ... Remote Utilization Management RN Leading healthcare facility...Remote Utilization Management RN Leading healthcare facility that aims to...need is now looking for a REMOTE Health Plan Nurse Coordinator to join their team! Here you will… more
- Centene Corporation (Phoenix, AZ)
- …ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Oversees the behavioral health...standards **Education/Experience:** Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 6+ years of related… more
- Dayton Children's Hospital (Dayton, OH)
- …Utilization Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management , the Utilization ... Excel, PowerPoint and Epic Systems preferred Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN: Registered Nurse … more
- Molina Healthcare (GA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... or more of the following activities: care review, care management , utilization management (prior authorizations,...experience. * At least 1 year of health care management /leadership experience. * Registered Nurse (RN), Licensed… more
- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... in standard medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care. + Knowledge of… more
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