Utilization Management Nurse

Job OverviewMEDNATIONAL is seeking an experienced Utilization Management (UM) Nurse to join our team. This role involves assessing healthcare services to ensure optimal patient outcomes and compliance with regulatory standards.Key Responsibilities:Service Assessment and Compliance: Evaluate healthcare services to guarantee optimal patient outcomes and...

Cynet Health is seeking a highly skilled Care Manager to join their team in the Emergency Department (ED) for a 9-month contract. This role requires strong leadership experience, excellent clinical expertise, and proficiency in utilization review and care coordination.Key Responsibilities:The successful candidate will be responsible for performing...

OverviewAt MJHS, we are dedicated to providing exceptional healthcare services to our patients and members. Our team of professionals works collaboratively to ensure that our health plans meet the needs of our diverse population.In this role as a Managed Care Nurse - Utilization Review Specialist, you will play a critical part in reviewing cases and...

Job Summary:SUNY Downstate Health Sciences University's Department of Care Management is seeking an experienced Utilization Review Nurse Specialist to support the review and management of patient care services.Key Responsibilities:* Complete and send initial clinical reviews within 48 hours of admission to payors via Care Management Module, CarePort.*...

About Managed Care NursingMJHS companies are committed to delivering high-quality managed care nursing services that meet the needs of our patients and members. Our goal is to provide personalized care that improves health outcomes and enhances the quality of life for those we serve.Job SummaryWe are seeking a skilled Pre-Authorization RN to join our team....

Job DescriptionAccenture is a leading global professional services company that helps the world's leading businesses, governments, and other organizations build their digital core, optimize their operations, accelerate revenue growth, and enhance citizen services by creating tangible value at speed and scale.We are a talent- and innovation-led company with...

Job Overview: As a Utilization Management Specialist in Healthcare Operations at Mount Sinai Health System, you will play a vital role in optimizing patient care and resource allocation.Salary:$ 84,000 per yearDescription:Develop and implement data-driven strategies to improve patient outcomes, reduce costs, and enhance the overall quality of...

At the New York State Office of Mental Health, we are seeking a skilled Healthcare Utilization Specialist to join our team.Job OverviewThe selected candidate will work with us to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness. This role is responsible for...

The MJHS team is committed to providing high-quality healthcare services to our patients and members.Salary: $85,000 - $110,000 per yearAbout UsAt MJHS, we believe that everyone deserves access to affordable and quality healthcare. Our Medicare and Medicaid managed care health plans are designed to help keep people independent and living life on their own...

The Metropolitan Jewish Health System is committed to providing high-quality healthcare services to our members, and we are seeking a skilled and experienced Pre-Authorization Nurse LPN to join our team. In this role, you will be responsible for performing case reviews and processing requests for elective services and durable medical equipment.You will work...

About the JobAs a Project Manager for Engineering Services at Innovative Consulting & Management Services, you will play a critical role in supporting the ARS NBAF Engineering Project Management Team (EPMG) and meeting the Facility's Service Contract, Construction Contract, and Operations Project Management goals for FY2024. This is an excellent opportunity...

Company OverviewTranscend Practice Management is a premier independent wealth management firm specializing in serving high-net-worth families, foundations, and trusts.Salary and BenefitsWe offer a competitive salary of $100K - $120K per year, along with benefits that include a monthly MTA pass and opportunities for career growth and professional...

TEPHRA OpportunityAs a Business Development Manager at TEPHRA, you will be responsible for executing sales and business development for Utilities Industries across Americas. This role is crucial in driving revenue growth and developing strategic relationships with decision-making CxO level executives at targeted accounts.The ideal candidate will have a...

About Sumitomo Mitsui Banking CorporationAs a top-tier global financial group, SMBC Group offers a diverse range of financial services, including banking, leasing, securities, credit cards, and consumer finance. With over 400 years of history, the Group has more than 130 offices and 80,000 employees worldwide in nearly 40 countries.In the Americas, SMBC...

Job SummaryWe are seeking an experienced Utility Sales Expert to join our team in North America. This individual will be responsible for executing sales and business development for Utilities Industries across Americas.About the RoleThe Business Development Manager position is a key sales role within the TCS IoT&DE Business Unit. The associate will develop...

About the Role:Are you a dedicated and experienced nurse looking to take on a leadership position? We have an exciting opportunity for a Nursing Operations Manager at AdvantageCare Physicians.This is a unique chance to utilize your clinical expertise and supervisory skills to drive quality patient care and optimize operational efficiency in our medical...

**About Us**Excel Sports Management is a leading sports agency representing top-tier talent, blue-chip brands, and marquee properties.We pride ourselves on being in the know and building relationships that matter for our clients. Our team is comprised of creatives, strategists, producers, designers, project managers, influencer managers, filmmakers,...

About the RoleThis exciting opportunity is available due to the growing demand for renewable energy solutions in the Northeast region. As a Solar Development Manager Professional, you will play a pivotal role in shaping the future of sustainable energy. Your expertise will drive the development of utility-scale and community solar projects, contributing...

Job OverviewBetances Health Center seeks a skilled Nurse Manager Specialist to lead our primary care practice and specialty services. This is a challenging role that requires exceptional leadership, patient education, and coordination skills.About the RoleThe successful candidate will report directly to the Nurse Manager and be responsible for providing...

Job OverviewMJHS Health System is a leading provider of healthcare services, dedicated to delivering high-quality care to our patients and members. As a Pre-Authorization Nurse at MJHS, you will play a critical role in ensuring that our patients receive the best possible care, while also contributing to the growth and development of our health plans.About...