utilization manager

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Raleigh Hospital, A Campus of Duke University Hospital Pursue your passion for caring with the Duke Raleigh...

Company DescriptionFounded in 1989, SOSi is among the largest private, founder-owned technology and services integrators in the defense and government services industry. We deliver tailored solutions, tested leadership, and trusted results to enable national security missions worldwide. Job DescriptionOverview Contingent Upon Contract Award SOS...

About Us Harris Health is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management...

About Duke Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range of medical, surgical, and diagnostic services, including orthopedics, weight‑loss surgery, women's services, and heart and vascular...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must reside in the state of Arizona. Position Purpose: Supervises Prior...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must reside in the state of Arizona. Position Purpose: Supervises Prior...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must reside in the state of Arizona. Position Purpose: Supervises Prior...

PA RN License RequiredWe are seeking an experienced Care Management Coordinator to join our Infusion Therapy team. This role is responsible for performing utilization management reviews to determine the medical necessity of requested healthcare services, ensuring members receive appropriate, evidence-based care while maintaining compliance with regulatory...

Job DescriptionJob DescriptionAbout us:Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert...

Description Utilization Manager As our Utilization Manager, you will coordinate Utilization Management functions for the agency. Trains staff on proper documentation, including assessments, treatment planning, progress notes, transition/discharge plans Provides feedback to staff regarding changes needed in order to meet service guidelines, fidelity review,...

Select how often (in days) to receive an alert: At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Regional Hospital Pursue your passion for caring with Duke...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must reside in the state of Arizona. Position Purpose: Supervises Prior...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must reside in the state of Arizona. Position Purpose: Supervises Prior...

Are you a Board Certified Medical Doctor (Family Medicine or Internal Medicine) looking for a full-time, remote job in a nonclinical setting?Then let me introduce you to ExamWorks!ExamWorks is seeking a physician board-certified in either Family Medicine, Internal Medicine to join the team full-time as a Utilization Management Physician Reviewer.This...

Mentor Technical Group (MTG) provides a comprehensive portfolio of technical support and solutions for the FDA-regulated industry. As a world leader in life science engineering and technical solutions, MTG has the knowledge and experience to ensure compliance with pharmaceutical, biotechnology, and medical device safety and efficacy guidelines. With offices...

Mercy is seeking a Utilization Management RN to support appropriate, cost-effective patient care across our Midwest network. The RN will review medical necessity, treatment plans, and level of care using established clinical criteria, collaborating with physicians, care managers, and payers. Responsibilities include chart review, authorization management,...

Company OverviewAcentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in...

Utility Managers and Supervisors are essential to keeping Hawaiʻi’s water and wastewater systems operating safely, efficiently, and in compliance with local, state, and federal regulations. They oversee staff, budgets, maintenance schedules, emergency planning, and public communication for water distribution systems, wastewater treatment plants, pumping...

Job Manager Under broad direction from the Sr. Director of Utilization Management, is responsible for the daily operations of the Centralized Utilization Management Programs for FMOLHS which serves infant, pediatric, adolescent, young adult, adult and geriatric patients. This position collaborates with department heads to comply with organizational...