• Manager , Utilization

    Humana (Jefferson City, MO)
    **Become a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral ... documentation, and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health… more
    Humana (03/12/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
    Beth Israel Lahey Health (02/09/25)
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  • Manager , Care Coordination…

    Stanford Health Care (Palo Alto, CA)
    …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning.… more
    Stanford Health Care (02/22/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management more
    Helio Health Inc. (03/04/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/199249/case- manager utilization - management ... and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more… more
    Prime Healthcare (03/08/25)
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  • Utilization Management Registered…

    McLaren Health Care (Indianapolis, IN)
    We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
    McLaren Health Care (03/08/25)
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  • Utilization Review Coord

    Covenant Health Inc. (Louisville, TN)
    …budgeted targets. + Provides medical/psychiatric leadership/consultation to Provider Relations, Medical Utilization Management , and Quality Management Staff ... of physicians on updated utilization review guidelines. + Participates in Utilization Management Committee. + Performs other related duties as required.… more
    Covenant Health Inc. (01/31/25)
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  • Utilization Review Coordinator

    Behavioral Center of Michigan (Warren, MI)
    …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... programs and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department regarding the… more
    Behavioral Center of Michigan (01/21/25)
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  • Behavioral Health Care Manager Lead…

    Elevance Health (Indianapolis, IN)
    …Skills, Capabilities and Experiences** : + Experience in Utilization Management preferred. + Board Certified Behavioral Analyst (BCBA) or Licensed ... and insightful analytics to improve the delivery of care._ ** Behavioral Health Care Manager Lead** **Location** :...review. **How you will make an impact:** + Coordinating utilization management process including appropriate use of… more
    Elevance Health (03/15/25)
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  • Case Manager , RN - Utilization

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200415/case- manager %2c-rn utilization ... services in specialties including Cardiovascular, Surgical, Orthopedics, Maternal-Child Health, Behavioral Health and Emergency and Trauma Care. In addition, the… more
    Prime Healthcare (03/15/25)
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