"Utilization Management (UM) Manager" Jobs in United States

Utilization Management (UM) Manager

Acentra Health ·

Acentra 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 rallyi

Clinical Guide Part A: (UM) Utilization Management Nurse

Devoted Health ·

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient, behavioral health, and/or post-acute authorization review in alignment with CMS

Utilization Management (UM) Clinical Support Specialist (Remote)

Tango ·

tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes

Pharmacist - Utilization Management (UM) - Remote

Highmark Health ·

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent e

Utilization Management (UM) Clinical Support Specialist

Tango ·

tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes

Utilization Manager II - UM System Services - Corporate Offices (Hybrid) - FT - Days

Sharp HealthCare · San Diego

Hours : Shift Start Time: Shift End Time: AWS Hours Requirement: Additional Shift Information: Weekend Requirements: On-Call Required: Hourly Pay Range (Minimum - Midpoint - Maximum): The stated pay scale reflect

Pharmacist - Utilization Management (UM) - (Remote)

Highmark Health ·

Company : Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinic

UTILIZATION MANAGMENT (UM) COORDINATOR - PRN

Rolling Hills Hospital · Franklin

Responsibilities At Rolling Hills, our mission is to offer compassionate, safe, effective behavioral healthcare treatment. We use solution-focused strategies and diligently strive for a safe and positive environment for

RN CLINICAL MANAGER - UTILIZATION MANAGEMENT (UM)

Covenant HealthCare · Saginaw

The Clinical Manager of the Utilization Management (UM) Department oversees the daily operations of the UM team. This position manages the Utilization Review Staff and ensures compliance with regulatory requirements rela

Utilization Management (UM) Trainer

OncoHealth ·

Oversee Training Design & Delivery Create consolidated training materials and framework for onboarding of CRS (Case Review Specialist) roles Ensure that training materials are customized to address key operational and sy

Utilization Management (UM) Clinical Support Specialist (Remote)

Tango ·

tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes

Sr. Manager, Medical Informatics - Utilization Management Analytics

BSC · Long Beach

Your Role The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our custome

Nurse Registered Utilization Management

St. Joseph's Health · Woodland Park

The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services in accordance with established criteria, regulatory requirem

Nurse Registered Utilization Management

St. Joseph's Health · Woodland Park

The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services in accordance with established criteria, regulatory requirem

Physician Advisor

MOSAIC · Saint Joseph

The Physician Advisor serves as a physician leader partnering with Care Management, Utilization Management (UM), Clinical Documentation Improvement (CDI), Health Information Management (HIM), Revenue Cycle, Quality, and