Utilization Management Jobs in USA

About the Role: You will provide daily support to Wellmark care management team members through making outbound calls to clinical staff regarding denials for services and admissions as well as scheduling peer to peer reviews for Medical this role you will complete prompt and professional outbound p...

FiltaClean Field Manager (Operations & Team Leadership) We are seeking a proactive and service-oriented Field Manager to oversee the operations and personnel for our FiltaClean services in the Atlanta area. This is a critical leadership role responsible for team development operational efficiency an...

Korzen Health is seeking an experienced and driven Primary Care Medical Director to partner with one of our established primary care group practices in Metro Raleigh NC. This is a full-time leadership opportunity combining clinical practice with medical directorship responsibilities. Position Overvi...

We are one of the largest dedicated Behavioral Hospitals in the Central Valley! We are looking to add a Medical Director to our team. The leadership has formulated a 7on/7off model for the new incoming Medical Director. Our hospital is a dedicated Psych Acute Care Hospital located in central Bakers...

Korzen Health is seeking a Medical Director for a Wound Care Center located in the heart of Syracuse NY. This position is based in our outpatient wound care clinic and is exclusively dedicated to procedural wound care. PRN shifts will depend on current provider availability/ general Our standard wor...

Job Summary Must have excellent understanding of benefits products and other health care and/or insurance issues as they pertain to customers (internal/external). This position is to provide service and support to managed care customers through verbal or written communication. This position acts as...

Location: Tallahassee Florida Position Title: Case Manager RN Position Type: Permanent / Contingent Available Shift Evening Shift: 12:00 PM 8:30 PM EST Schedule: 1 weekend per 4-week cycle Job Summary We are seeking an experienced Case Manager RN to join a 288-bed acute care setting serving Le...

ContractWe are recruiting for a Utilization Management Coordinator (UMC) to join an established healthcare organization in Sacramento. The UM Coordinator supports activities related to authorization processing for outpatient inpatient and ambulatory services. This is a contract to hire opportunity!...

Job DetailsRN Case Manager - Utilization Management - Day ShiftMon - Fri (Hours: 8 a.m. to 4:30 p.m.) Weekend requirements based on unit needs. Elkton MDChristianaCare - Union Hospital is seeking Utilization Management Nurse with experience in Utilization Management and Acute Care. The RN will be re...

DescriptionThe Program Director (Licensed) is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and value-based care populations. This role drives cost-effective high-quality post-acute care through strategic partnerships data-driven performance oversight clin...

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier com...

At Johnson & Johnsonwe believe health is everything. Our strength in healthcare innovation empowers us to build aworld where complex diseases are prevented treated and curedwhere treatments are smarter and less invasive andsolutions are our expertise in Innovative Medicine and MedTech we are unique...

ERG is a research and consulting firm that provides a wide range of support to federal state and commercial clients. ERG offers multidisciplinary teams with nationally recognized skills in engineering science economics public health informational technology and communications. We hire people with th...

As the Field Account Manager you will be responsible for the growth of revenue by proactive sales of the product portfolio in its territory and developing strong customer relations according to the organizational strategy for its assigned customer base.The ideal candidate will be located in the San...

*** This is a remote position. ***Salary Range: $80K-100K base salaryPreferably - DFW AREAMust Reside in the U.SDirect Sales Experience Required.JAFRA COSMETICS INTERNATIONAL is looking for you.Jafra is a fun direct selling company that has been part of the industry since 1956. We work to create an...

At Johnson & Johnsonwe believe health is everything. Our strength in healthcare innovation empowers us to build aworld where complex diseases are prevented treated and curedwhere treatments are smarter and less invasive andsolutions are our expertise in Innovative Medicine and MedTech we are unique...

Medical Director (DVM) Stockton CAA well-established small animal practice in Stockton CA is seeking an experiencedVeterinarian to step into a Medical Director role. This position offers the perfect balance of clinical practice and leadership with the flexibility to shape medical protocols mentor a...

Medical Director (DVM) Yuma AZAn established small animal practice in the Yuma Arizona area is seeking a Medical Director to guide a dedicated medical team while providing exceptional patient care. This opportunity is ideal for a doctor ready to take the next step in their career combining clinica...

Medical Director (DVM) Stockton CAA well-established small animal practice in Stockton CA is seeking an experiencedVeterinarian to step into a Medical Director role. This position offers the perfect balance of clinical practice and leadership with the flexibility to shape medical protocols mentor a...

Medical Director (DVM) Chaska MNA well-established small animal practice in Chaska MN is seeking a Medical Director to guide its clinical team and support the continued advancement of patient care. This role is ideal for a veterinarian who enjoys leading others fostering collaboration and setting m...