RN Manager of Utilization Management

Job SummaryWe are seeking a highly skilled Outpatient UM Clinician to join our team at MedPOINT Management. As a key member of our Utilization Management department, you will play a critical role in ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesReview and process precertification requests for medical necessity,...

Job SummaryFamily Health Centers of San Diego is seeking a skilled Utilization Management RN to join our team. As a Utilization Management RN, you will play a critical role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key ResponsibilitiesConduct prospective, initial, and retrospective reviews of inpatient,...

Job OverviewPosition: Outpatient Utilization Management Specialist at MedPOINT ManagementRole SummaryThe Outpatient Utilization Management Specialist is essential in enhancing communication between Managed Services Organizations (MSO), Independent Physician Associations (IPA), and members to guarantee seamless member care. Key responsibilities include...

Job SummaryWe are seeking a skilled Case Manager Utilization RN to join our team at Recruitics JB. As a key member of our multidisciplinary team, you will play a vital role in coordinating and screening for the appropriateness of admissions and continued stays. Your expertise will be instrumental in making recommendations to physicians for alternate levels...

Job SummaryKaiser Permanente is seeking a skilled Case Manager Utilization RN to join our team. As a key member of our healthcare team, you will play a critical role in coordinating and managing the care of our patients.Key ResponsibilitiesCollaborate with Physicians: Work closely with physicians to develop and implement individualized plans of care that...

Job Summary:We are seeking a skilled RN Utilization Case Manager to join our team at Recruitics JB. As a key member of our multidisciplinary team, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. Your expertise will be essential in making recommendations to physicians for...

Job SummaryWe are seeking a skilled Case Manager Utilization RN to join our team at Recruitics JB. As a key member of our multidisciplinary team, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays.Key ResponsibilitiesDevelop and implement individualized plans of care to ensure...

Job SummaryWe are seeking a skilled RN Case Manager Utilization Specialist to join our team at Kaiser Permanente. As a key member of our healthcare team, you will play a critical role in coordinating and managing patient care to ensure the highest quality outcomes.Key ResponsibilitiesCollaborate with physicians and other healthcare professionals to develop...

Job OverviewThe Outpatient Utilization Management Coordinator serves as the primary liaison between the Outpatient Utilization Management (UM) team and Health Plan representatives. This position is responsible for managing referral requests directed to Health Plans, including but not limited to tertiary care, durable medical equipment, and pharmacy services,...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse, Senior to join our team at Blue Shield of CA. As a key member of our Utilization Management team, you will play a critical role in reviewing inpatient stays for our members and ensuring that nationally recognized levels of care are applied correctly.Key ResponsibilitiesPerform...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse, Senior to join our team at Blue Shield of CA. As a key member of our Utilization Management team, you will play a critical role in reviewing inpatient stays for our members and ensuring that nationally recognized levels of care are applied correctly.Key ResponsibilitiesPerform...

Job SummaryWe are seeking a highly skilled Utilization Manager to join our team at APLA Health. The successful candidate will be responsible for managing the daily operations of Utilization Management (UM) and ensuring that all processes, programs, and operations meet internal, government, health plan/IPA, and medical group requirements.Key...

Manager, Utilization Management Location: Los Angeles, CA, US Compensation: $165,000 - $175,000 + Bonus + SIGNING BONUS + Paid Relocation *RN Required* On-Call Rotation Required The Manager of Utilization Management oversees the daily functions of the Utilization Management Program within the designated Service Area or Medical Center. This role is pivotal in...

Job SummaryWe are seeking a skilled Complex Case Manager Utilization RN to join our team at Recruitics JB. As a key member of our multidisciplinary team, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays.Key ResponsibilitiesDevelop and implement individualized plans of care to...

Your RoleThe Facility Compliance Review team conducts thorough reviews of post-service prepayment facility claims to ensure compliance with contract requirements, industry standards, and medical necessity. As a Utilization Management Nurse, Senior, you will play a critical role in this process.Key ResponsibilitiesReview medical documents and apply clinical...

Job SummaryWe are seeking a skilled RN Case Manager Utilization Specialist to join our team at Recruitics JB. As a key member of our multidisciplinary team, you will work collaboratively with physicians and other healthcare professionals to coordinate and screen for the appropriateness of admissions and continued stays.Key ResponsibilitiesDevelop and...

Nurse Manager - Utilization ManagementAt Necnic Group, LLC, we are seeking a skilled Nurse Manager to lead our Utilization Management Program. As a key member of our team, you will be responsible for ensuring cost-effective and quality patient care by optimizing resource utilization.Key Responsibilities:Develop and maintain policies and procedures for...

Necnic Group, LLC is seeking a highly skilled Nurse Manager - Utilization Management to lead our Utilization Management Program in the Service Area or a Medical Center. Job Summary:As a key member of our team, you will be responsible for ensuring cost-effective and quality patient care by appropriate utilization of resources. You will provide direction to...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse to join our team at Presidential Staffing Solutions, LLC. As a Utilization Management Nurse, you will play a critical role in ensuring the efficient and effective delivery of patient care.Key ResponsibilitiesReview patient files and treatment information to identify opportunities for...

Job SummaryWe are seeking a skilled RN Case Manager to join our team at Recruitics JB. As a Utilization Case Manager, you will play a critical role in coordinating and screening patient admissions and continued stays, working collaboratively with physicians to ensure the most cost-effective care without compromising quality.Key ResponsibilitiesDevelop and...