- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care.… 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...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… 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 ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- Baylor Scott & White Health (Dallas, TX)
- …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... in Microsoft Office and medical documentation systems. + Case management certifications, such as Certified Case Manager ,...Case management certifications, such as Certified Case Manager , are beneficial but not necessary for this position.… 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 ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Empire State Development, NYS Title Project Manager , Utilization - MWBE Occupational Category Other Professional Careers Salary Grade NS ... the direct supervision of the Director of Contract Participation, the Project Manager , Utilization , will lead the planning, execution, and monitoring of… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director, Utilization Management , provides organizational leadership in the operational areas of appeals, utilization review, ... policy and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical Affairs. ; **Work… 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 ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… more
- Elevance Health (Cerritos, CA)
- ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time in **CALIFORNIA** , with the ... skill development. _Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance...shift between 8 am - 5 pm PST. The ** Utilization Management Representative II** is responsible for… more
- Elevance Health (Wallingford, CT)
- ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
- Elevance Health (Mason, OH)
- ** Utilization Management Representative II** **Schedule: Monday-Friday 8am-5pm Eastern Time** **Must be located in the state of Ohio** **Virtual** : This role ... onboarding and skill development. _Please note that per our policy on hybrid /virtual/ work, candidates not within a reasonable commuting distance from the posting… more
- CenterWell (Tampa, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements ... caring community and help us put health first** The Manager Care/Case Management in **Tampa area (**...action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market leaders on team-based… more
- AON (Chicago, IL)
- …Nothing in this job description restricts management 's right to assign or reassign duties and responsibilities to this job at any time. #LI- HYBRID #LI-MM2 ... an outstanding role for you! This role is a hybrid role based out of our Chicago, IL office....is different: + Collaborate with Account Specialist staff, Account Management team, and Client Service Delivery Leaders to establish… more
- Cedars-Sinai (CA)
- …and/or RWB), preferred. \#LI- Hybrid **Req ID** : 10337 **Working Title** : Manager , Data Analytics & Delivery - Hybrid **Department** : EIS MNS Decision ... " list, which highlights hospitals that have excelled in the utilization of electronic functionalities, telemedicine, digital imaging, artificial intelligence and… more
- The Cigna Group (Bloomfield, CT)
- …a Lean Portfolio Manager , you will be responsible for overseeing the management and optimization of our large and complex project portfolio. You will work ... **This is a hybrid position (3 days per week in-office +...IFP customers. We are looking for a Lean Portfolio Manager to join our team and help us drive… more
- Stanley Black and Decker (Towson, MD)
- **Project Manager -** **Packaging Hybrid ** This is a hybrid role and requires to be on-site in Towson, MD, three days a week. **Come build something that ... CADET(R), and HUSTLER(R). **The Job: ** As a Project Manager - Packaging with extensive project management ...of our Tools and Outdoor Team working as a hybrid employee. **You'll** **get to:** + Leads & Drives… more
- Hubbell Power Systems (Shelton, CT)
- Manager , Real Estate - Shelton, CT ( Hybrid ) Apply now " Date: Sep 26, 2025 Location: Shelton, CT, US, 06484-4300 Company: Hubbell Incorporated Job Overview Are ... real estate initiatives on a global scale? Hubbell is looking for a Manager , Real Estate to drive innovation, efficiency, and growth across its diverse portfolio… more
- RTX Corporation (East Hartford, CT)
- …or participating in investigations & disclosures. - Support requirements for training and utilization of P&W and RTX GT management tools. - Identify training ... Street, East Hartford, CT, 06118 USA **Position Role Type:** Hybrid **U.S. Citizen, US Person, or Immigration Status Requirements:**...for a highly motivated **Military Engines Global Trade Senior Manager ** to join our team! The position will be… more
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