Utilization Management Jobs in USA

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...

Anticipated End Date:Position Title:Clinical Pharmacist - CarelonRxJob Description:Clinical Pharmacist CarelonRxLocation: This role requires associates to be in-office 1 - 2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life bala...

Position Title: Registered Nurse (RN) Case ManagerLocation: Mission Viejo California Facility Type: Acute Care Hospital Duration: 13 Weeks Unit: Case ManagementScheduleDay Shift: 08:00 AM 04:30 PM5x8-hour shifts40 hours per weekWeekend rotation required (every other weekend)Pay RateLocal: Up to $4...

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...

Anticipated End Date:Position Title:Pharmacist Clinical Senior - CarelonRxJob Description:Pharmacist Clinical Senior CarelonRxLocation: This role requires associates to be in-office 1 - 2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and...

We are recruiting for a mission-driven Director Pharmacy - Denver Health Medical Plan (* Hybrid Work Schedule *) to join our team!Were with you for lifes journey. At Denver Health purpose isnt just something we believe inits something we live every day for lifes journey. Our ValuesRespect Belongin...

Employment Type:Full timeShift:Day ShiftDescription:POSITION PURPOSEThe Pharmacy Manager Operations is a licensed registered pharmacist accountable for managing and advancing people processes and / or programs that support direct or indirect patient care. This opportunity functions as the manager f...

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...

ENL Case ManagementCompensation range:$58.56 - $79.06Your rate of pay will be based on applicable experienceShift: Days Days off: Variable Hours per pay period: 80 Shift length: 8 HoursEnloe Health is a Level II Trauma...

ABOUT MARINHEALTHAre you looking for a place where you are empowered to bring innovation to reality Join MarinHealth an integrated independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team an affiliation with UCSF Health an ever-expanding...

Job DetailsClinical Transformation ArchitectJob DescriptionThe Quality Program and Value Architect serve as a strategic leader responsible for optimizing Jeffersons performance across valuebased care programs quality incentive models and clinical documentation accuracy. This role ensures the organiz...

Its more than a career its a calling.OK-SSM Health St. Anthony Hospital - Oklahoma CityWorker Type:RegularJob Summary:Assesses develops plans implements and evaluates patients discharge planning needs to next level of care in collaboration with interdisciplinary team.Job Responsibilities and Require...

Hi were Oscar. Were hiring a Senior Product Manager Authorization Services to join our Product team.Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance...

Its more than a career its a callingMO-SSM Health St. Marys Hospital - St. LouisWorker Type:RegularJob Highlights:Take your nursing career to the next level by becoming SSM Healths newest RN Case Manager!Schedule: 8am-4:30pm Monday-Friday no weekendsLocation: St. Marys Hospital - St. LousRequirement...

Job DetailsThe Delegated Vendor Program Manager is responsible for the strategic oversight and operational performance of HHAeXchange as a primary delegated partner for Jefferson Health this role you serve as the central point of contact for the HHAX platform ensuring it effectively supports the di...

Employment Status:Full timeShift:Weekends Only (United States of America)Facility:1906 Belleview Ave SE - RoanokeRequisition Number:R159918 RN Case Manager - ED Observation Unit - Full time - Weekends (Open) How Youll Help Transform Healthcare:The RN Case Manager provides case management fo...

Working with UsChallenging. Meaningful. Life-changing. Those arent words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here uniquely interesting work happens every day in every department. From optimizing a production line to the latest breakthrou...

Role: Junior Behavioral Health ABA Clinical Review & Authorization Support Location: USA Remote (candidate should be willing to work in EST time zone) Years of experience:2-3 years Role Summary Seeking fully licensed behavioral health clinicians to support Applied Behavior Analysis (ABA...

Job DescriptionSpectrum Healthcare Resources has a potential opportunity for a Registered Nurse Utilization Management at Nellis Air Force Base in Las Vegas NV.Position Benefits:8 and 10-hour shifts offeredSchedule: Monday - Friday (40 hours/week)No on-call or holiday requirementsBenefits offered:...