Utilization Management Jobs in USA

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...

City/StateVirginia Beach VAWork ShiftFirst (Days)Overview:OverviewReporting to the division president and as a member of the division leadership team the VP Chief Medical Officer is accountable for the clinical performance improvement including the promotion of clinical appropriateness the reduction...

Lifekind Health is looking for an experienced Licensed Clinical Social Worker (LCSW) or Licensed Marriage & Family Therapist (LMFT) to join our team full-time. Deliver evidence-based psychological and behavioral health services to patients receiving care in a transdisciplinary pain management settin...

Employment Type:Full timeShift:Day ShiftDescription:The Health Alliance Clinical Teamis now hiring for an Nurse Patient Navigatorto join their wonderful team!The Health Plan & Patient Navigator serves as a critical resource for colleagues and patients by providing care navigation and coordination se...

The Senior Director Coverage Review Client Operations is an enterprise leadership role accountable for setting the strategic direction operational standards and regulatory integrity of Coverage Review clientfacing operations across Evernorth / Cigna Healthcare. This role provides executive ownership...

Job DetailsThe Healthcare Economics (HCE) teams primary function is to provide various clinical and financial analyses to management to support the business decision addition the team will provide consistent accurate reports to help management from other departments do their jobs more effectively.T...

Site: Mass General Brigham Health Plan Holding Company Inc.Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and com...

Role Overview We are seeking an experienced Salesforce Health Cloud Technical Lead to lead the design development and delivery of scalable Salesforce solutions within the Health Cloud and Life Sciences domain. This role requires deep technical expertise across the Salesforce platform strong DevOps a...

Anticipated End Date:Position Title:Nurse Case Manager LeadJob Description:Telephonic Nurse Case Manager Lead Location: This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. This approach promot...

DSV - Global transport and logisticsIn 1976 ten independent hauliers joined forces and founded DSV in Denmark. Since then DSV has evolved to become the worlds 3rdlargest supplier of global solutions within transport and logistics. Today we add value to our customers entire supply chain by transporti...

ATTENTION MILITARY AFFILIATED JOB SEEKERS- Our organization works with partner companies to source qualified talent for their open roles. The following position is available toVeterans Transitioning Military National Guard and Reserve Members Military Spouses Wounded Warriors and their Caregivers. I...

The Senior Clinical Pharmacist Drug Evaluation Unit is responsible for developing clinical evaluations and key clinical assessments for new therapies new indications and utilization management clinical policies on traditional and specialty pharmaceuticals. This pharmacist will support the provision...

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards as a...

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards as a...

Site: Mass General Brigham Health Plan Holding Company Inc.Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and com...

Hours:Shift Start Time:8 AMShift End Time:5 PMAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:No WeekendsOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$36.830 - $47.530 - $53.230The stated pay scale reflects the range that Sharp reasona...

Job DetailsAre you looking to work for a company that is based on excellence and love Then this is the position you need to check out!ChristianaCare is one of the countrys most dynamic healthcare organizations centered on improving health outcomes making high-quality care more accessible and lowerin...

City/StateNorfolk VAWork ShiftFirst (Days)Overview:Sentara Norfolk General Hospital is hiring a Supervisor MSW Inpatient Case Management.This is a full-time 40 hour per week position.Requirements:-Masters Degree in Social Work (MSW)-Licensed LMFT LPC LCSW or LPC-3 years clinical experience-3 years r...

Job DetailsRN Case Manager Weekender - Day ShiftSaturday & Sunday (Plus one rotating Friday shift).Newark DEChristianaCare - Wilmington Hospital is currently recruiting an RN Case Manager - Weekender with experience in Transitional Care or Discharge Planning in an Acute Care Hospital SettingAs part...

Job Description: Summary:This position assists the Chief Medical Director to direct and coordinate the medical management quality improvement and credentialing functions for the business unit. This role supports the HARP line of business. Essential Accountabilities:Level IProvides medical leadership...