Utilization Management Jobs in USA

OverviewThe Care Coordinator is a member of the multidisciplinary team that actively facilitates those functions that move a patient through an acute episode of care and links to internal and external resources and the payor community. The Care Coordinator assumes responsibility and leads the proces...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

OverviewThe Care Coordinator is a member of the multidisciplinary team that actively facilitates those functions that move a patient through an acute episode of care and links to internal and external resources and the payor community. The Care Coordinator assumes responsibility and leads the proces...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Overview:$5000 Sign-On Bonus for new-to-NCH employeesMonday - Friday 8 a.m. - 5 p.m.Full-Time 1.0 FTE 40 hour per weekLearn about Care Navigation: Experience: our website: Description Summary:

Anticipated End Date:Position Title:Nurse Reviewer IIJob Description:Nurse Reviewer IILocation: This role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy. This approach promotes productivity supports work-life...

Anticipated End Date:Position Title:Psychologist Reviewer - part timeJob Description:Work location: VirtualThis role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. This approach promotes productivi...

Pay Range:$64600.00 - $96800.00Please emailif you are a candidate seeking a reasonable accommodation for the application and/or interview process.At BCBSRI our greatest resource is our people.We come from varying backgrounds different cultures and unique experiences. We are hard-working caring and c...

Anticipated End Date:Position Title:Psychologist Reviewer - GeorgiaJob Description:Psychologist ReviewerHybrid 1: This role requires associates to be in-office1-2days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. This app...

JOIN US IN MAKING THE MOST OF EVERY DAY!Hospice of The Western Reserve operates in celebration of the individual worth of each life we strive to relieve suffering enhance comfort promote quality of life foster choice in end-of-life care and support effective grieving.WHY USWe believe that our succes...

DescriptionRegistered Nurse (RN) - Case ManagerJob Type: PRN M-Sun 8a-430pYour experience mattersConemaugh Memorial Medical Center is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-bein...

Anticipated End Date:Position Title:Director Special Programs Clinical Advisory-Healthy Blue Care TogetherJob Description:Director Special Programs Clinical Advisory-Healthy Blue Care TogetherWe are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support M...

Position Description:CGI is seeking a versatile Healthcare Data Scientist/Engineer to join our team supporting CGI PulseAI for Healthcare delivery. This role is critical in bridging the gap between raw healthcare data and actionable insights. You will be responsible for designing and maintaining rob...

Anticipated End Date:Position Title:Sr Director AI Enablement Product & PlatformsJob Description:Sr Director AI Enablement Product & PlatformsLocation: Atlanta GA. This role requires associates to be in-office 3 days per week fostering collaboration and connectivity while providing flexibility to su...

DescriptionRegistered Nurse (RN) - Case ManagerJob Type: Full Time M-F 730-400 or 8-430 rotating weekends on callYour experience mattersConemaugh Memorial Medical Center is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profoun...

Anticipated End Date:Position Title:Behavioral Health Care ManagerJob Description:Behavioral Health Care Manager ILocation: Virtual Colorado This role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy. This appro...

DescriptionWho weareFounded in 1999 and headquartered in Central Ohio were a privately-owned independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone and were on a mission to make healthcare simpler and more effective...

Job Family:Strategy & Transformation Consulting (Payer Provider)Travel Required:Up to 75%Clearance Required:NoneThe Director in clinical and operational improvement will be dedicated to the profitable growth of the firms Healthcare Payer Provider optimization group. The ideal candidate will bring e...

DescriptionThe Case Manager 1 directs the utilization review of patient charts treatment plans and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager 1 specializes in the review of information pertaining specifically to...