Utilization Management Specialist

At Sargent & Lundy, we are committed to delivering exceptional results for our clients. We are seeking a highly skilled Utility Transmission Specialist to lead our team of engineers and designers in the design, modification, and analysis of new and existing high voltage substations.The successful candidate will have a strong background in project management...

Job OverviewWe are seeking a skilled Clinical Utilization Specialist to join our team. In this role, you will play a vital part in reviewing and evaluating Utilization Management (UM) plans for prospective and existing Medical Groups/IPAs in the HMO networks.Key Responsibilities:Reviews UM/QR plans to ensure compliance with HMO standards and...

About the RoleWe are seeking an Utility Interconnection Specialist to join our team.In this role, you will be responsible for managing our New York interconnection portfolio and collaborating with internal teams to facilitate interconnection application submittals.ResponsibilitiesDevelop and maintain accurate records throughout the interconnection...

Job SummaryWelcome to Guidehealth, a data-powered healthcare company dedicated to operational excellence. We are seeking an experienced Registered Nurse with a passion for utilization review and patient care. As a Nurse Utilization Specialist, you will play a vital role in ensuring that our clients receive high-quality, cost-effective care while maintaining...

About the OpportunityAre you a detail-oriented and analytical professional looking for a challenging role? Do you have experience in commercial banking, credit analysis, and portfolio management? If so, we invite you to apply for the position of Power and Utilities Credit Specialist at Associated Bank.In this role, you will be responsible for analyzing...

At First Community Management, we strive to create a positive work environment where our managers can make a meaningful impact in the world of community management. As a Portfolio Management Specialist, you will be responsible for overseeing a portfolio of communities, ensuring efficient management and effective communication with boards, internal...

We are looking for a seasoned Electric Utility Design Specialist to join our team at KDM ENGINEERING LLC. As a key contributor to our engineering department, you will be responsible for developing teams of talented engineers, driving excellence and quality, and mentoring less experienced staff.The successful candidate will have a bachelor's degree in...

About UsLeidos is a diverse and fast-paced organization committed to delivering exceptional results. We are currently seeking a skilled Sr. Utility Infrastructure Specialist to join our Chicago-based team.This role offers an exciting opportunity to lead and design high-voltage utility civil substation projects while working collaboratively with other...

About Elevance Health: We are a healthcare company dedicated to improving lives and communities through innovative solutions and compassionate care. Our mission is to make healthcare simpler and more accessible to our members and the communities we serve.">Job Summary: We are seeking a skilled Clinical Reviewer I-5 to join our team and conduct...

About the RoleThe Utilization Management Coordinator will play a critical role in ensuring the effective implementation of Utilization Management (UM) plans for Medical Groups/IPAs in the HMO networks. This position requires strong analytical and communication skills, as well as a deep understanding of managed care principles and UM/QR processes.Key...

About UsLa Rabida Children's Hospital is a leading pediatric hospital in Chicago, IL, dedicated to providing high-quality care to children with complex conditions, disabilities, and chronic illnesses.Job DescriptionWe are seeking a highly skilled Care Management and Utilization Leader to join our team at La Rabida Children's Hospital in Chicago, IL. This is...

Clean Energy Leadership RoleWe're seeking a skilled Clean Energy Project Coordinator to join our team at New Leaf Energy, LLC.Key ResponsibilitiesThis role involves managing approximately 100 active interconnection applications across multiple utilities and service territories. The successful candidate will coordinate interconnection activities, manage...

About the RoleWe are seeking a highly skilled and experienced Clinical Utilization Management Specialist to join our team at Mindlance. In this role, you will be responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by Medical Groups/IPAs participating in the networks of Client's HMOs.The ideal...

Streamlining Healthcare OperationsAs an ED Utilization Review/Case Manager at Insight Hospital and Medical Center, you will play a crucial role in optimizing patient flow and resource utilization.This position requires a deep understanding of healthcare operations and the ability to communicate effectively with various stakeholders, including healthcare...

Key ResponsibilitiesThe ideal candidate will possess excellent clinical judgment and communication skills, with the ability to work effectively in a fast-paced environment.Your primary duties will include:Conducting initial medical necessity clinical screenings and determining whether the presented information meets medical necessity criteria.Notifying...

Global Channel Management OverviewAs a leading provider of global channel management solutions, we understand the importance of secure and efficient directory services. Our team is committed to delivering exceptional results and building strong relationships with our clients. We are seeking an experienced Identity Management Specialist to join our team.Job...

Transform Your Career with Aramco Services CompanyWe are a leader in the global energy sector, with a strong commitment to responsible operations and sustainable practices. Our legacy of excellence spans nearly nine decades, with a proven track record of managing vast hydrocarbon resources and delivering significant socioeconomic benefits worldwide.Join our...

Join Our TeamAnkura Consulting Group, LLC is seeking a highly skilled Physician Medical Director - Utilization Management to join our team. As a critical member of our healthcare operations group, you will be responsible for leading utilization management efforts and providing expertise in medical necessity and clinical documentation.This role is an...

Job Summary:RHP Risk Management is seeking a highly experienced senior-level Health Sciences Regulatory Specialist to join our team. As a senior leader, you will be responsible for managing technical report preparations through delegation to junior staff and providing oversight. You will also participate on RHP's Senior Leadership Team to help steward the...

Company OverviewHBK Engineering, LLC is a leading provider of utility infrastructure solutions. Our team supports underground facility construction activities to prevent damage and protect electrical utility infrastructure.Job SummaryWe are seeking a Utility Locator to join our team. This role involves responding to dig ticket requests, locating and marking...