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Manager- Utilization Management
Greenville, North Carolina, United States
$92k-$134k/yr OnsiteFull Time
3+ YOEBachelor's degree in nursing, 3+ years related experience, experience with utilization review, regulatory compliance, and clinical decision tools (MCG/InterQual).
MCG, InterQual
2mo
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Director, Utilization Management
New York, New York, United States
$155k-$237k/yr OnsiteFull Time
Senior-level leadership in utilization management with healthcare regulatory knowledge.
2w
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Utilization Management Nurse
Nashville, Tennessee, United States
OnsiteFull Time
3+ YOEPerform prospective/concurrent/retrospective utilization reviews, analyze trends, collaborate with providers, and document reviews; RN license and 3+ years utilization management experience required.
2mo
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Utilization Management Nurse
United States
$80k-$95k/yr RemoteFull Time
3+ YOERN with 3-5 years in utilization management; risk-based care experience; data-driven decision making; strong communication and leadership.
1mo
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Utilization Management Supervisor
United States
$68k-$106k/yr RemoteFull Time
5+ YOE2+ MgmtBachelor's in Nursing; active Indiana RN license; 5 years nursing/patient care experience; 2 years utilization or case management preferred.
1mo
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Utilization Management Specialist II
Baltimore, Maryland, United States
OnsiteFull Time
1+ YOEMaryland RN or equivalent license (or Compact-eligible), 12+ months case/utilization management experience, knowledge of utilization management, strong verbal/written communication and analytical skills, ability to work with hospital/utilization management software.
5d
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Manager Utilization Management
Topeka, Kansas, United States
$116k-$145k/yr HybridFull Time
5+ YOERequires BSN or bachelor's, active RN, 5+ years clinical and utilization management experience, knowledge of medical necessity and UM best practices, strong communication and data analysis skills.
PCC, Agile, Scrum
3mo
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Utilization Management RN
Paterson, New Jersey, United States
OnsiteFull Time
3+ YOEBSN required; 3+ years nursing experience; 3+ years utilization review/case management preferred; CCM certification preferred; NJ RN licensure required.
1w
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Utilization Management Technician
Lincoln, Nebraska, United States
OnsiteFull Time
2+ YOESupports utilization management by obtaining and documenting insurance-related forms, explaining notices to patients, assisting with admission notifications, and participating in denials/appeals; clinical experience preferred.
1mo
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Supervisor Utilization Management
Lewiston or Salt Lake City or Renton or Medford or Portland or Boise or Spokane or Burlington or Fargo or Vancouver
$81k-$142k/yr HybridFull Time
5+ YOE3+ MgmtBachelor's in nursing or related, current unrestricted RN license, 5+ years clinical experience, 3+ years leadership, state license/certification allowing assessments, clinical utilization management competency.
2mo
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Director, System Utilization Management
New Orleans, Louisiana, United States
OnsiteFull Time
7+ YOE7–10+ years leadership in Utilization Management or Case Management; RN preferred with certification in CM/UM; Epic EMR knowledge; BSN required, MSN preferred.
Epic, Healthcare Data Analytics, Microsoft Excel
2w
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Supervisor, Utilization Management
Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming or Phoenix
$101k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtActive RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet, Internet, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Current Procedural Terminology, Healthcare Common Procedural Coding System, American Dental codes
2mo
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Utilization Management Nurse
Dalton, Georgia, United States
OnsiteFull Time
3+ YOERN license; 3 years clinical experience preferred; 1-2 years utilization review preferred; proficient in Microsoft Office; NCQA knowledge preferred; ability to manage multiple projects.
Microsoft Office
3w
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Utilization Management Analyst
Fairfax County, Virginia, United States
$71k/yr OnsiteFull Time
Knowledge of inpatient psychiatric treatment, utilization management, third-party reimbursement, and regulatory requirements; ability to conduct chart and continued-stay reviews, communicate with clinicians and payers, produce reports, and write policies.
Microsoft Word, Microsoft Excel, AVATAR, EHR
2w
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Utilization Management Nurse
Chapel Hill, North Carolina, United States
RemoteFull Time
2+ YOEActive RN licensure required, 2+ years UM team experience in managed care, BLS not explicitly stated; proficiency with Microsoft Office, MCG and CMS criteria, utilization review and benefit interpretation skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, MCG, CMS
1w
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Utilization Management Nurse
Annapolis or Lanham
$34-$55/hr HybridFull Time
3+ YOECurrent Maryland RN license, BSN (or ADN with equivalent experience; BSN to be completed within 5 years), 3 years acute care nursing, chart review and utilization management experience, EPIC proficiency.
EPIC
2w
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RN UTILIZATION MANAGEMENT SPECIALIST
Saginaw, Michigan, United States
OnsitePart Time
Active Michigan RN license required. Preferred 3 years utilization management experience. Must demonstrate clinical competence, denial/appeals and utilization management skills, strong written/verbal communication, and solid computer skills.
InterQual, Epic, EHR
1w
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UTILIZATION MANAGEMENT COORDINATOR
Sautee, Georgia, United States
OnsiteFull Time
1+ YOEReview insurance benefits, determine level of care using ASAM criteria, document authorizations, coordinate peer reviews and after-care; HS/GED required, bachelor's preferred, 1+ year utilization review/case management or facility psychiatric/substance abuse experience preferred.
2w
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Utilization Management Coordinator
Salt Lake City, Utah, United States
HybridPart Time
2+ YOE2 years healthcare experience or equivalent; understanding of medical terminology; prior utilization review experience; ability to check eligibility, obtain records, and communicate authorization decisions.
CPT, ICD-10, HCPCS, Utilization Management Platform
1d
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Utilization Management Coordinator
Southfield, Michigan, United States
HybridPart Time
2+ YOEAssociate's degree required; RN license in Michigan required upon hire; 2 years clinical/hospital experience and hospital utilization review experience; clinical appeals preferred.
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