- Ascension Health (Nashville, TN)
- …Saint Thomas hospitals throughout the TN market . We're looking for an experienced Director of Utilization Management to join our team! In this pivotal ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...root-cause analysis to enhance our processes. You'll collaborate with Market Care Management , Finance, CDI, and Physician… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for… more
- ERP International (Nellis AFB, NV)
- …No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality ... disciplines to include discharge planning and referrals for case management . * Utilization management duties...appropriate health plan. Collaborates, coordinates with TOPA and Referral Management Director when needed in accordance with… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... lower cost of care. + Candidate will be responsible for the oversight of the utilization management team. + Responsible for a team of clinicians who conduct… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
- The Hartford (King Of Prussia, PA)
- … will provide direct underwriting leadership, sales leadership, and agency management for the Middle Market Underwriting Center (MMUC). Responsibilities ... Promotes utilization of services: Claims and Risk Engineering Middle Market Underwriting Operations + Inspires team to achieve operating plan objectives through… more
- Jacobs (Sacramento, CA)
- As a Market Growth Director ( Market GD) you report to your assigned Executive Director of Sales (EDS). You are responsible for the development of a ... strategy to include input and create alignment with the Lead Account Strategist (LAS), the Director of Operations (DO) aligned to your market , and Market … more