Utilization Management Jobs in USA

At least 3 years of experience in Immunology with experience in Managed Health Care Payer Account Management and/or Access and ReimbursementThorough understanding of the technical payer policy processes systems and requirements for coverage coding and payment for specialty medicinesDemonstrated unde...

Leads the direction planning execution and interpretation of clinical trials or research activities of one or more clinical development programs. Participates in and may lead cross-functional teams to generate deliver and disseminate high-quality clinical data supporting overall product scientific a...

ResponsibilitiesManages the design and implementation of one or more clinical development programs in support of an overall Product Development Plan based on strong medical and scientific principles knowledge of compliance and regulatory requirements AbbVies customers markets business operations and...

Leads the direction planning execution and interpretation of clinical trials or research activities of one or more clinical development programs. Participates in and may lead cross-functional teams to generate deliver and disseminate high-quality clinical data supporting overall product scientific a...

We are seeking a Medical Director. This position will report to the Senior Medical Director of Pharmacovigilance and will be located in the Waltham office.The Medical Director is responsible for global pharmacovigilance (PV) for marketed and/or investigational products including review and analysis...

ResponsibilitiesManages the design and implementation of one or more clinical development programs in support of an overall Product Development Plan based on strong medical and scientific principles knowledge of compliance and regulatory requirements AbbVies customers markets business operations and...

SUMMARYWe are seeking a technically strong Product Owner to lead the evolution and optimization of our core utilization management applications. This role owns workflow optimization and routing logic to ensure our platforms effectively support clinical review authorization decisioning and operationa...

RESPONSIBILITIES:Provide individual supervision to assigned home visitors on a weekly basisArranges for regular shadow home visits for quality assurance with assigned superviseesEducate and support staff regarding clinical issues such as maternal health pregnancy child development and parent child i...

Doka USA is seeking an Area Manager to lead and support our Mid Atlantic branch while overseeing business development and performance across the assigned territory. This role is responsible for the overall leadership performance and profitability of the branch ensuring operational excellence while d...

Meet Leaf Home. We turn complex home improvement projects and endless to-dos into achievements. With more than 50% of homeowners worried about the cost and effort of home maintenance we deliver remarkable end-to-end experiences. And get the job done right at every step. Bringing innovative products...

US Medical Affairs Oncology (USMAO) is advancing a bold transformation to realize our aspirations for Customer 2030 (C2030) Future of CRM (FoCRM) and Future of Field Medical (FoFM). We are building a modern Medical organization where digital fluency datadriven insight and humancentered engagement en...

Liberty Healthcare seeks to hire an Internal Medicine or Family Medicine Physician for a full-time Medical Director position at DHCI in Smyrna Delaware.DHCI is a highly rated 200-bed skilled nursing facility which provides an array of residential medical and therapy services to older adults as well...

OverviewLegacy Health has an opportunity for a Hospitalist leader to join the Emanuel team. This position directs all aspects of hospitalist team operations to ensure alignment with the mission values and strategic objectives of the organization. Responsible and has authority to recruit & retain the...

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...

Anticipated End Date:Position Title:LTSS Service Coordinator (Case Manager) South Central OhioJob Description:LTSS Service Coordinator (Case Manager)Candidates should live in one of the following counties: Hocking Licking Madison Morgan Monroe Noble Perry or Union County.Location: This field-based r...

Anticipated End Date:Position Title:LTSS Service Coordinator - Case Manager (Lee/Sarasota County)Job Description:LTSS Service Coordinator (Bilingual in Spanish/English)Schedule: Monday-Friday 8am-5pm ESTLocation: This is primarily a field based position. Candidate would need to reside in one of the...

Anticipated End Date:Position Title:LTSS Service Coordinator - Case Manager (Bay/Escambia/Santa Rosa)Job Description:LTSS Service Coordinator Schedule: Monday-Friday 8am-5pm ESTLocation: This is primarily a field based position. Candidate would need to reside in one of the following counties: Bay Ca...

Anticipated End Date:Position Title:LTSS Service Coordinator - Case Manager (Pasco/Pinellas)Job Description:LTSS Service Coordinator (Bilingual in Spanish/English)Schedule: Monday-Friday 8am-5pm ESTLocation: This is primarily a field based position. Candidate would need to reside in one of the follo...

Anticipated End Date:Position Title:LTSS Service Coordinator - Case Manager (Broward County)Job Description:LTSS Service Coordinator (Bilingual in Spanish/English)Schedule: Monday-Friday 8am-5pm ESTLocation: This is primarily a field based position. Candidate would need to reside in one of the follo...