Utilization Management Jobs in USA

Status: Full Time Hourly FLSA Classification: Non-ExemptSummary of Position: The Qualified Mental Health Professional Community Services (QMHP-CS) is responsible for providing Targeted Case Management and Rehabilitative Services to youth with serious emotional disturbances and their families.Serv...

The Clinical Care Manager is responsible for utilization management by conducting utilization review activities population management cross-system consultation provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of best practices and eviden...

Inspire health. Serve with compassion. Be the difference.Job SummaryProvides primary health care to a specific patient population within the guidelines of written protocols. Follows established nursing standards procedures and practices.AccountabilitiesEngages in the diagnosis and treatment of dise...

Inspire health. Serve with compassion. Be the difference.Job SummaryProvides primary health care to a specific patient population within the guidelines of written protocols. Follows established nursing standards procedures and practices.AccountabilitiesEngages in the diagnosis and treatment of dise...

OverviewNorthside Hospital is award-winning state-of-the-art and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a...

Find your calling at Mercy!The Nurse Navigator is a leader providing support mentorship and guidance to those who provide direct patient care. The Nurse Navigator coordinates the delivery of patient care by assessing care requirements of the individual patient and makes recommendations based on seve...

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...

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...

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...

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...

The Business Project Senior Advisor will report to the Cigna Pharmacy Business UM Operationalization team and play a critical role in leading and supporting high-profile initiatives and complex issue resolution. This role requires deep expertise in pharmacy and medical claims prior authorization (PA...

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...

OverviewSelect Specialty HospitalCritical Illness Recovery Hospital (LTACH)Director of Case ManagementSalary Is Based On Prior Years of Relevant Experience: $85-$115000$10000 Sign On BonusFull Time: Monday - Friday 8-5pmClinical license as a registered nurse or respiratory therapist or masters in so...

OverviewSelect Specialty HospitalCritical Illness Recovery Hospital (LTACH)Case Manager (PRN)Social Work OnlyPrevious discharge planning experience highly preferred.SHIFT:*Availability to work a minimum of 2 shifts per month on an as needed basis - shifts would be scheduled on weekdays from appoxima...

OverviewSelect Specialty HospitalCritical Illness Recovery Hospital (LTACH)Case Manager (PRN)Licensed Social Work OnlyPrevious discharge planning experience highly preferred.SHIFT:*Availability to work a minimum of 2 shifts per month on an as needed basis - shifts would be scheduled on weekdays from...