- Appcast (Randallstown, MD)
- …activities as required by payor. Monitors and identifies patterns or trends in utilization management . Monitors potential and actual denials and coordinates with ... Utilization Review Nurse RN Randallstown, MD NORTHWEST HOSPITAL...with the discharge plan arranged by attending and Care Management personnel. Coordinates with the Care Manager … more
- CHRISTUS Health (Macdona, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …immunotherapy in the treatment of multiple myeloma.Legend Biotech is seeking Senior Project Manager , Site PMO as part of the Technical Operations team based in ... OverviewThis position will be responsible for providing operational excellence project management support to the cGMP Clinical and Commercial Cell Therapy… more
- Kaiser (Lanham-Seabrook, MD)
- …environmental factors, and response to treatment so as to decrease inappropriate utilization of medical services.In close collaboration with the nurse case ... manager and other members of the health care team,...and timely manner.Ensures consistent and reliable documentation of case management activities in compliance with all organization and department… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …stakeholders including but not limited to Operations, MSAT, Facilities, C&Q, Project Management , and Quality.Work closely with Sr. Manager , Strategic Initiatives ... of site operational models to better understand and assess resource utilization , equipment utilization , change impact, etc.Support assessment of facility… more
- Daiichi Sankyo, Inc. (Phoenix, AZ)
- …strong, long-term relationships with clinical personnelEnsures appropriate and compliant utilization of product and disease state education as it relates ... customer needs.Monitor, collect, and communicate to the Director, Clinical Nurse Manager on customer insights regarding their need for information regarding disease… more
- JobElephant (Bowling Green, OH)
- …managing and leading the operational and logistical functions for BGSU Firelands Events Management activities. This position acts as project manager for external ... Space; Set-up; Dates/Times). All records must be entered into the event management system for all event information and contracts, R25 for space reservations,… more
- Kaiser (Arlington, VA)
- …environmental factors, and response to treatment so as to decrease inappropriate utilization of medical services.In close collaboration with the nurse case ... manager and other members of the health care team,...and timely manner.Ensures consistent and reliable documentation of case management activities in compliance with all organization and department… more
- Jooble (Alamogordo, NM)
- …The Certified Occupational Therapy Assistant reports directly to the department manager and/or his/her designee with clinical supervision provided by a licensed ... occupational therapist. Responsible for utilization and supervision of volunteers, students, and support staff relating to the provision of occupational therapy… more
- Walt Disney Company (New York, NY)
- …execution of comprehensive programs focusing on security, profit protection, incident management , and compliance. The Asset Protection Manager utilizes advanced ... Assistant Manager Asset Protection Retail StoresThe Asset Protection ...enhance performance and leadership capabilities. Provide coaching and performance management as required to constantly grow and develop team… more
- The Career Sphere (Los Angeles, CA)
- …policies and procedures? Work in conjunction and collaboratively with the Nurse Manager and Clinic Manager to establish effective efficient streamlined processes ... customer service, and clinic flow.? With the help of clinic management and administrative assistance, manage provider panels, provider schedules, vacations, absences… 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 ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review,… 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
- 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 ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of… 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
- 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
- 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
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …a web-based application for daily entry of case activity and the utilization management of service authorizations. Educational and Experience Requirements: MA/MS ... Salary: $65,000/year Position Summary: The UM Program Manager provides oversight and management of...summ ar ize d ata wit h in the Utilization M an agementSys tem to pr eparere por… 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
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
