- Ochsner Health (New Orleans, LA)
- …at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management ) serves as the physician leader in matters relating ... Interdisciplinary and Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act as a… more
- Centene Corporation (Phoenix, AZ)
- …to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... adherence to performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH care member issues related to BH… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Tufts Medicine (Burlington, MA)
- … Review and Discharge Planning including implementation and annual review of the Utilization Management Plan and assisting with the coordination of the ... Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization Program that integrates the functions… more
- Humana (Louisville, KY)
- …our caring community and help us put health first** The Associate Director, Utilization Management utilizes clinical nursing skills to support the coordination, ... of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing requires a solid understanding of how… more
- Truman Medical Centers (Kansas City, MO)
- …log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity - ... Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN)** _Optimize Care. Improve Outcomes. Elevate the… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / ... + FTE:0.01 + Posted:April 15, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring… more
- Intermountain Health (Murray, UT)
- …service lines of business(s). The position requires an understanding of utilization management industry benchmarks, best practices and regulatory environment ... programs to impact trends. + Uses a data-driven approach to assess utilization management and care management operations and make program recommendations. +… more
- Hackensack Meridian Health (Hackensack, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- Crouse Hospital (Syracuse, NY)
- …education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and ... it relates to the utilization of services. Pay Range: $80,000.00/year+ Utilization Management RNs are eligible for up to a $20,000 Sign-On Bonus! Available… more