Utilization Management Nurse

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 Title: Utilization Management Program DirectorManagement Business Solutions is seeking a highly skilled Utilization Management Program Director to lead our team in providing exceptional patient care and ensuring cost-effective utilization of resources.Key Responsibilities:Develop and maintain policies and procedures for Utilization ManagementCollaborate...

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 Title: Utilization Management NurseWe are seeking a 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.Job SummaryThe ideal candidate will have a strong background in nursing, with a...

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.ResponsibilitiesReview patient files and treatment information to identify opportunities for...

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 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...

Director of Utilization ManagementThe Director of Utilization Management plays a pivotal role in overseeing the Case Management and Utilization Review program. This individual is responsible for developing and managing programs that emphasize appropriate admissions, concurrent and retrospective review of care, and other integrated functions such as Discharge...

Job Title: Utilization Management Nurse, SeniorAbout the Role:The Utilization Management Nurse, Senior will play a critical role in ensuring that our members receive the most appropriate care possible. As a member of the Utilization Management team, you will be responsible for reviewing inpatient stays to determine medical necessity and ensuring that our...

RN Manager of Utilization Management Job SummaryThe RN Manager of Utilization Management is a key role in our healthcare organization, responsible for overseeing the coordination of services through an interdisciplinary process. This position requires a strong leader who can balance individually identified patient and family needs with cost-effective...

Job SummaryThis is a challenging and rewarding role that requires a strong background in healthcare operations and management. As a Utilization Manager at APLA Health, you will be responsible for overseeing the daily operations of our Utilization Management (UM) program, ensuring that all processes and programs are fully implemented and compliant with...

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...

Job Title: Utilization Management Case ManagerTake on a vital role within a leading health organization, UCLA Health, and contribute to ensuring smooth and efficient case management processes to support quality care.Key Responsibilities:Process and manage authorization requests, including urgent, routine, pre-service, and retro authorizations.Prepare and...

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 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 SummaryWe are seeking a skilled and compassionate Case Manager Utilization RN to join our team at Kaiser Permanente. 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...