178 utilization management jobs at 101 companies in Middletown, DE
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.
3d
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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
1w
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Utilization Management Supervisor (Hybrid)
Baltimore, Maryland, United States
$83k-$171k/yr HybridFull Time
3+ YOERN licensure, 3+ years medical/surgical experience, knowledge of utilization review and accreditation standards, supervisory experience, strong analytical and communication skills, Microsoft Office proficiency.
Microsoft Office
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
3w
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Supervisor of Utilization Management
Philadelphia, Pennsylvania, United States
FieldFull Time
5+ YOE2+ MgmtBachelor's in health or human services; current clinical license (e.g., RN or SW); CCM credential or obtain within 24 months; BLS/CPR; 5+ years care management experience with 2+ years supervisory experience; strong analytics and communication.
Microsoft Office, EHR
2d
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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.
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
2w
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Registered Nurse Utilization Review
Baltimore, Maryland, United States
$81k-$116k/yr HybridFull Time
Maryland RN credential required; diploma from accredited nursing school or equivalent licensure; experience in utilization/case management preferred; knowledge of clinical documentation and payer regulations.
1mo
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Manager for Case Management- Bayview Location
Baltimore, Maryland, United States
$95/hr OnsiteTemporary
5+ YOE1+ MgmtCurrent RN licensure in MD, CPR required, ACM or CCM certification within 2 years, 5+ years case management experience, 1+ year leadership experience, knowledge of utilization management and Medicare regulations.
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.
2d
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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
3w
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Customer Growth Strategy Manager | Utilities
New York or Milwaukee or Dallas or Columbus or Kirkland or Cincinnati or Cleveland or Oklahoma City or Austin or Albany or Chicago or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Mountain View or Scottsdale or San Francisco or Morristown 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
$87k-$294k/yr OnsiteFull Time
6+ YOE6+ years strategy/management consulting experience with utilities/customer service focus; 3+ years experience in design, analytics, or implementation; 1+ year utilities client experience; hands-on AI/GenAI and automation experience; Bachelor’s or equivalent.
Salesforce, Dynamics, Amazon Connect, Genesys, NICE
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
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