203 utilization management jobs at 108 companies in Elsmere, DE
4d
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Utilization Management Nurse
Philadelphia, Pennsylvania, United States
$92k-$117k/yr OnsiteFull Time
5+ YOEAssess clinical data for medical necessity, coordinate utilization reviews, validate authorizations with payers and physicians; requires RN (PA), 5+ years acute clinical nursing, knowledge of payer processes and portal navigation.
Microsoft Office, InterQual
1mo
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
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.
Microsoft Office
1mo
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
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.
Microsoft Office
14h
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Manager of Utilization Management
Philadelphia, Pennsylvania, United States
FieldFull Time
5+ YOE2+ MgmtRequires an RN license, 5+ years in discharge planning and care coordination, 2+ years management or 4+ years supervisory experience, clinical leadership, data analysis, and Microsoft Office proficiency.
Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, MCG, InterQual, Electronic Medical Record (EMR)
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
2mo
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Utilization Review Specialist
Chadds Ford, Pennsylvania, United States
HybridFull Time
1+ YOEBachelor's degree in a related field, 1+ years utilization review/case management or behavioral health revenue cycle experience, strong understanding of medical necessity and authorization processes, attention to detail, and strong communication skills.
EHR
1mo
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Utilization Specialist- OMY
Philadelphia, Pennsylvania, United States
OnsiteFull Time
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
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.
1mo
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Senior Manager, Project Management
Monrovia or Los Angeles or Reading
$184k-$270k/yr OnsiteFull Time
15+ YOE12+ Mgmt15+ years in power/utilities (12+ in project management), Bachelor's/Master's in Engineering or equivalent, PE preferred, project management certification preferred, Microsoft Office proficiency, leadership and financial management experience.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Teams
2d
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Utilization Management & Clinical Validation RN
Newtown Square or United States
$60k-$107k/yr RemoteFull Time
3+ YOEUnrestricted RN license in state of residence, 3+ years clinical experience, 2+ years clinical validation/appeals experience, knowledge of coding guidelines and appeal construction, strong writing and typing skills.
Word, Verint, HR Direct
1mo
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Senior Manager, Project Management
Los Angeles or Long Beach or Monrovia or Reading
$184k-$270k/yr OnsiteFull Time
15+ YOE12+ MgmtSenior leader with 15+ years in power/utilities including 12+ years in project management; experience delivering transmission, distribution, substation and grid modernization projects; Bachelor's/Master's in engineering or equivalent; PE and PM certifications preferred; Microsoft Office proficiency.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Teams
2w
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Operations Supervisor
Conestoga, Pennsylvania, United States
$120k-$135k/yr OnsiteFull Time
5+ YOE5+ years control room or power plant operations experience; ability to read electrical/hydraulic/mechanical prints; clear communication; MS Office proficiency; ability to lead teams and work independently.
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Teams
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.
3d
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RN Case Manager - Utilization Review (Temple Hospital Jeanes Campus)
Philadelphia, Pennsylvania, United States
HybridFull Time
2+ YOEActive PA or multi-state RN license, BSN required, minimum 2 years clinical nursing experience preferred; experience with utilization review/InterQual/MCG and Medicare/Medicaid guidelines; strong clinical judgment and communication.
InterQual, MCG
4d
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Utilities Transmission & Distribution Field Service/EAM Manager or Senior Manager
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 Atlanta or Redmond or Bentonville or Beaverton or Nashville or Detroit or San Diego
$113k-$338k/yr HybridFull Time
5+ YOERequires 5+ years in gas or electric utilities, 5+ years in utility EAM and field scheduling or mobility systems and processes, team or workstream leadership, client management, and a bachelor's degree or equivalent experience.
IBM Maximo, SAP PM, IFS MWM, CGI PCAD, Salesforce, Artificial intelligence (AI)
1mo
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Project Manager - Cincinnati, OH
King of Prussia or Lorton or Columbia Station or Cincinnati
FieldFull Time
2+ YOEManage utility construction projects; minimum 2 years project management in utility/heavy construction; proficient in Microsoft Word/Excel/Project; travel frequently (~80%); PMP/CCM desired.
Microsoft Word, Microsoft Excel, Microsoft Project, Primavera P6
1d
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Transmission Line Engineering Consultant 2 - Grid
Reading, Pennsylvania, United States
$145k-$222k/yr HybridFull Time
10+ YOE7+ MgmtBachelor's degree in ABET-accredited engineering or management/business, 10+ years in the electric utility industry, and 7+ years managing utility transmission projects; team leadership required.
3w
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Director of Power Operations
Voorhees, New Jersey, United States
RemoteFull Time
Experience leading large-scale distribution, transmission, substation, or utility infrastructure projects; managing construction operations and field teams; and business development in the utility market.
2w
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Project Construction Manager - Water Utility Infrastructure
Philadelphia, Pennsylvania, United States
FieldPart Time
5+ YOEBachelor's degree required, 5+ years construction management experience on water utility projects, OSHA safety knowledge, leadership, and proficiency with Procore and Autodesk Construction Cloud.
Procore, Autodesk Construction Cloud
2mo
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Manager, Energy Efficiency
Fort Washington, Pennsylvania, United States
OnsiteFull Time
Bachelor’s degree or equivalent; experience in energy management, utilities, or property operations; strong customer engagement, knowledge of utility billing structures, and multi-system data workflows; proficient with Excel; Salesforce and Yardi a plus.
Salesforce, Yardi, CRM, Billing tools, Microsoft Excel