52 utilization management jobs at 29 companies in Delaware
1d
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Utilization Management Nurse Consultant
Michigan or Arkansas or Georgia or Texas or Minnesota or Iowa or Wisconsin or New York or Kansas or Indiana or Connecticut or New Jersey or Rhode Island or Louisiana or Tennessee or Kentucky or Mississippi or Ohio or Oklahoma or Massachusetts or Maryland or Alabama or South Carolina or Missouri or Virginia or Illinois or North Carolina or Florida or Pennsylvania or New Hampshire or Delaware
$29-$62/hr RemoteFull Time
3+ YOERequires 3+ years as an RN, unrestricted RN licensure, an associate nursing degree, and experience with IT systems and Microsoft Office; utilization management experience is preferred.
Microsoft Office, Microsoft Outlook, Microsoft Teams, Microsoft Excel
3d
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Wound Care Utilization Management RN
Indianapolis or Iselin or Tampa or Miami or Wilmington or Cincinnati or St. Louis or Walnut Creek or Las Vegas or Woburn or Grand Prairie or Chicago or California or Illinois or Massachusetts or Nevada or New Jersey
$39-$56/hr RemoteFull Time
3+ YOERequires an associate degree in nursing or equivalent background, 3+ years of healthcare experience, active unrestricted RN license, and wound-care certification such as WOCN or CWS.
medical records
2w
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RN Utilization Management - Day Shift
Newark, Delaware, United States
$86k-$137k/yr OnsiteFull Time
3+ YOEDE or compact RN license, Bachelor’s in Nursing required, minimum 3 years acute care RN and 3 years utilization management, denial management and insurer experience, 8 CEUs/year in utilization/case management.
2w
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Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for Substance Abuse - Flexible Weekend Dayshift - Remote in VA and NC
Norfolk or Alabama or Delaware or Florida or Georgia or Idaho or Indiana or Kansas or Louisiana or Maine or Maryland or Minnesota or Nebraska or Nevada or New Hampshire or North Carolina or North Dakota or Ohio or Oklahoma or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or Washington or West Virginia or Wisconsin or Wyoming
RemoteFull Time
2+ YOEMaster's in counseling/social work/MFT (or BSN for RN), valid state license (LCSW/LPC/LMFT/RN), 2 years behavioral health and 1 year case management, ASAM/substance use experience preferred.
1w
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Strategy Consultant - Utilization Management and Medical Policy
Pennsylvania or Maryland or Washington or North Carolina or Louisiana or Kentucky or Kansas or Indiana or Illinois or Georgia or Iowa or Florida or Colorado or California or Delaware or Connecticut or Arkansas or Arizona or Alabama or Alaska or Nevada or Vermont or Tennessee or Idaho or Oklahoma or Hawaii or Mississippi or Utah or New Hampshire or New Mexico or Wyoming or North Dakota or South Dakota or Rhode Island or West Virginia or Montana or Texas or District of Columbia or Ohio or New Jersey or Oregon or South Carolina or Missouri or Virginia or Massachusetts or Nebraska or Minnesota or Michigan or Wisconsin or New York or Maine
$109k-$181k/yr RemoteFull Time
6+ YOEMasters in Business/Healthcare/Economics required (or Bachelor's with experience),6+ years related experience (or 2 years post-grad consulting plus 6 years related),healthcare strategy experience,advanced data modeling and analytics skills.
SQL, Python, R, Power BI, Tableau, Microsoft PowerPoint, Microsoft Excel, EHR, ICD-10
2mo
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Utility Construction Management Associate 2
Irving or Delaware
HybridPart Time
5+ YOEKnowledge of AREMA standards; general construction practices; proficiency with electronic communications; High School Diploma; 5-7 years railroad/utility experience.
2mo
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Utility Construction Management Associate 2
Delaware, United States
OnsitePart Time
5+ YOEHigh School diploma; 5-7 years railroad or utility experience; valid driver’s license; ability to rent/operate rental cars; AREMA knowledge; proficient in electronic communications.
Tablet, Email, Text messaging, AREMA standards
1w
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Case Management RN
Wilmington, Delaware, United States
OnsiteFull Time
5+ YOEDiploma/associate required (BSN preferred). Active RN license, case management/utilization management certification preferred, minimum 5 years progressive clinical experience including utilization/case management, maintain DE state and federal clearances.
4d
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UR Supervisor
Michigan or Pennsylvania or Wisconsin or Illinois or Colorado or Georgia or South Dakota or Oregon or Kentucky or Maryland or Missouri or Utah or Delaware or Indiana or New Hampshire or Idaho or Tennessee or Florida or Oklahoma or Washington or Arizona or Nevada or United States
$65k-$70k/yr RemoteFull Time
5+ YOE5+ years utilization review/chart analysis experience in psychiatric/chemical dependency preferred; bachelor's preferred; experience with Milliman/InterQual, EMR and Salesforce; strong communication and clinical decision-making skills.
Microsoft Office, Salesforce, EMR, Milliman, InterQual
1mo
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Field Construction Manager
Newark, Delaware, United States
FieldFull Time
10+ YOE10+ years relevant construction experience (or bachelor's in engineering preferred). Experience with electrical utility/substation/transmission projects, SCADA, commissioning, safety leadership, QA/QC, and field construction management.
SCADA
2d
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Assistant Commissioning Project Manager, PV
California or Kentucky or Louisiana or Maine or Maryland or Massachusetts or Michigan or Minnesota or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Jersey or New Mexico or New York or North Carolina or North Dakota or Ohio or Oklahoma or Oregon or Pennsylvania or Rhode Island or South Carolina or South Dakota or Tennessee or Utah or Vermont or Virginia or Washington or West Virginia or Wisconsin or Wyoming or Texas or Alabama or Arizona or Arkansas or Colorado or Connecticut or Delaware or Florida or Georgia or Idaho or Illinois or Indiana or Iowa or Kansas
$92k-$115k/yr HybridFull Time
3+ YOERequires 3+ years testing and commissioning utility-scale electrical systems, power systems expertise, project team management, stakeholder coordination, problem-solving, organization, communication, and U.S. work authorization.
P6, SCADA, DCS, LOTO, National Electrical Code (NEC), National Fire Protection Association (NFPA), IEEE, IES, API, NETA, NERC, ISO, TSO
1mo
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Operations Project Manager - ERS
Dover or United States
FieldFull Time
10+ YOE10+ years field service experience in power plants/utilities, strong high-voltage equipment and commissioning background, leadership experience, knowledge of NETA and electrical safety, proficiency with Microsoft Office and PowerDB, valid driver's license.
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Teams, PowerDB, SharePoint
3w
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Training Supervisor
Newark, Delaware, United States
$97k-$133k/yr OnsiteFull Time
4+ YOE4-7 years utility experience required; supervisory experience evaluated and may require a Supervisory Assessment; bachelor\u0002s degree preferred; knowledge of collective bargaining processes.
3w
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Project Director, FEP
Delaware or Pennsylvania or Virginia or North Carolina or South Carolina or Georgia or Florida or Texas
HybridFull Time
15+ YOEBachelor's degree required, master’s preferred; 15+ years leading large capital programs; experience with utility/energy infrastructure projects; executive stakeholder engagement; valid driver’s license; PMP preferred.
2w
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Appeals and Grievances Clinical Specialist
New York City or Lake Mary or New York or North Dakota or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Kansas or Illinois or Iowa or Georgia or Florida or Delaware or Connecticut or Colorado or New Hampshire or Vermont or Arizona or Alabama or Maine or Utah or Mississippi or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Oklahoma
$73k-$120k/yr RemoteFull Time
Active registered nurse (rn) required; experience in appeals & grievances, utilization review, claims processing preferred; familiarity with Utilization Review guidelines and care management systems; strong documentation and case management skills.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
2w
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Utility Foreman
Dover, Delaware, United States
OnsiteFull Time
3+ YOE3–5 years utility construction experience, supervisory experience preferred, ability to read plans, operate/ work around heavy equipment, enforce OSHA safety, valid driver's license, strong communication and organizational skills.
3mo
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Clinical Director
Wilmington or United States
$160k-$175k/yr RemoteFull Time
5+ YOEPharmacist (R.Ph. or Pharm.D.) with 5+ years PBM experience, team leadership, project management, PBM/drug utilization analysis, and strong communication; MS Office proficiency required.
Insights, Marketplace, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook
4d
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Transmission Line Engineering Consultant 2 - Grid
Wilmington, Delaware, United States
$145k-$222k/yr HybridFull Time
10+ YOE7+ MgmtABET-accredited BS degree, 10+ years electric utility experience, 7+ years transmission project management, strong communication, PMP and design/construction experience preferred.
1mo
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General Utility Worker Lead (Newark, DE, US, 19716)
Newark, Delaware, United States
OnsiteFull Time
Experience in utility or dishroom roles, ability to train staff, knowledge of sanitation and kitchen equipment cleaning, independent judgment, and ability to perform physical tasks (lifting, bending, standing).
1mo
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REMOTE - Vice President Medical Director of Clinical Programs
Massachusetts or Maryland or Nevada or Vermont or Missouri or South Dakota or Kansas or Louisiana or Arkansas or Mississippi or New York or Oklahoma or Virginia or Rhode Island or New Hampshire or Minnesota or Kentucky or Arizona or Georgia or Florida or Connecticut or North Carolina or Wisconsin or Delaware or Indiana or Nebraska or District of Columbia or South Carolina or Texas or Pennsylvania or Alabama or Ohio or New Jersey
RemoteFull Time
10+ YOEMD/DO with board certification, 10+ years clinical and health plan medical director experience, managed care/utilization/quality expertise, strong analytics, executive communication, and Microsoft Office proficiency.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
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