563 utilization jobs at 246 companies in Bethlehem, PA
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Utilization Review Coordinator
Allentown, Pennsylvania, United States
$20/hrRemoteFull Time
Pyramid Healthcare: Operates facilities for addiction recovery and mental health treatment.
3+ YOEAssociate degree required, 3+ years utilization review or related healthcare experience, intermediate Microsoft Office/Excel skills, knowledge of precertification/appeals and medical records.
Rutgers University: Providing higher education degrees and conducting academic research.
3+ YOERequires RN license in New Jersey or Bachelor's in mental health, 3+ years mental health experience, utilization review and data entry skills preferred, ability to conduct reviews and communicate outcomes.
Conduct concurrent utilization reviews for psychiatric and residential drug/alcohol clients using ASAM criteria; coordinate appeals, maintain authorization and denial logs, and communicate with payers and treatment teams.
Malvern Health: Provides specialized inpatient and outpatient behavioral health treatment.
Master's degree or nursing graduate with Pennsylvania licensure; knowledge of ASAM and medical necessity criteria; utilization review experience preferred; Microsoft Office and billing experience; strong communication and documentation skills.
Manager Utilization Review - FT - Day - Utilization Resource Mgmt Trenton NJ
Trenton, New Jersey, United States
$98k-$128k/yrOnsiteFull Time
Capital Health: Provides comprehensive healthcare services through hospitals and medical clinics.
4+ YOEBSN required (ADN with additional experience may be considered), active NJ RN, BLS recommended, 4+ years nursing experience with utilization review/case management, strong analytical and leadership skills.
WES Health System: Provides behavioral health and intellectual disability support services.
2+ YOEBachelor's in human services/care management, 2 years mental health or social services experience, familiarity with EHRs, proficient with Microsoft Office, strong communication and analytical skills.
EHR, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
Eagleville Hospital: Specialty hospital providing addiction and mental health treatment services.
3+ YOE3+ years UR or case management experience in Substance Use / Behavioral Health; good communication; ability to work independently; MS Office experience; knowledge of pre-certification, DSM V, private care managers, and county referrals.
Saint Peter's Healthcare System: Provides comprehensive acute care and specialized medical health services.
3+ YOEActive New Jersey RN license, 3+ years acute care nursing experience, ability to assess clinical records for medical necessity, strong communication and computer skills.
Jefferson: Providing healthcare services and academic programs in Pennsylvania.
2+ YOEMaster of Social Work and 2 years hospital social work experience required; performs psychosocial assessment, discharge planning, counseling, and multidisciplinary collaboration.
Hopewell or Newark or New Jersey or New York or Pennsylvania or Connecticut or Delaware
$71k-$94k/yrRemoteFull Time
Horizon Blue Cross Blue Shield of New Jersey: Provides health insurance and managed care products in New Jersey.
2+ YOEAssociate/bachelor/diploma in nursing, active unrestricted NJ RN license, minimum 2 years clinical experience, knowledge of utilization/case management, proficiency with MS Office and Windows, strong analytical and communication skills.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Windows, intranet, internet
Energy Distribution Partners: Distributes propane and provides HVAC services across the United States.
Valid Class A or B CDL with Hazmat and Tanker endorsements, safe driving record, ability to lift up to 75 lbs and pull up to 125 lbs, willingness to work on-call and follow safety procedures.
ARRO Consulting: Engineering and environmental consulting firm providing municipal infrastructure services.
5+ YOEHigh school diploma, minimum 5 years operations or engineering experience, water/wastewater license preferred, ability to perform fieldwork and physical tasks.
Utilization Management Medical Director - Medical Oncology - Remote anywhere in US
Houston or Chicago or Atlanta or Phoenix or Los Angeles or Saint Louis or San Diego or Dallas or Philadelphia or Seattle
$249k-$373k/yrRemoteFull Time
UnitedHealth GroupNYSE: UNH: Provides health insurance and technology-enabled health care services.
5+ YOEMD or DO with current medical license; Board Certification in Oncology; 5+ years clinical experience in oncology; NCCN guideline experience; able to support utilization review and case/disease management.
Denver or Philadelphia or Redlands or Remote Eligible
$80k-$133k/yrRemoteFull Time
Esri: Developing software for digital mapping and spatial data analysis.
2+ YOE2+ years in utilities/telecommunications with ArcGIS; ArcGIS Utility Networks; GIS workflows; strong communication; Bachelor in geography or related field.
Edgewood Properties: Develops and manages residential and commercial real estate properties.
2+ YOEBachelor’s degree in Finance, Accounting, Business Administration, or related field; 2+ years in utilities/accounts payable; proficient in Excel; knowledge of utility billing; strong analytical and organizational skills.
New York City or Milwaukee or Herndon or Dallas or Columbus or Kirkland or Irvine or Cincinnati or Cleveland or Oklahoma City or Austin or Albany or Chicago or Arlington or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Mountain View or Scottsdale or Morristown or San Francisco or Denver or Boston or Philadelphia or Des Moines or Overland Park or Los Angeles or Charlotte or Walnut Creek or Carmel or Seattle or Houston or Arlington or Atlanta or Redmond or Bentonville or Beaverton or Nashville or Detroit or San Diego
$139k-$434k/yrHybridFull Time
AccentureNYSE: ACN: Global provider of management consulting and technology services.
10+ YOE10+ years in utility GIS solution architecture with full‑lifecycle ArcGIS Utility Network implementations; experience advising utility executives, defining enterprise GIS architecture, and leading large transformation programs; must be eligible to work in the US and willing to travel.
Shaheed A. Smith Geospatial: Provides professional land surveying and geospatial mapping services.
10+ YOE5+ Mgmt10+ years in SUE/utility locating with 5+ years in leadership; expert in EM locating, GPR, CAD/GIS; strong client relations and budgeting.
AutoCAD Civil 3D, GNSS, GIS, EM locating equipment, GPR