161 utilization management jobs at 93 companies in Townsend, DE
4d
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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.
9h
Save
Mark Applied
Hide
Director of Case Management
Baltimore, Maryland, United States
$58-$104/hr OnsiteFull Time
3+ YOE4+ MgmtMaster's degree required; 3-4 years of experience and progressive leadership preferred, with case management, social work, or utilization review experience required. Maryland or DC RN licensure required.
computer software applications
1mo
Save
Mark Applied
Hide
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.
1w
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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)
3w
Save
Mark Applied
Hide
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
Save
Mark Applied
Hide
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
1mo
Save
Mark Applied
Hide
Project Manager - Substation and Transmission Line Team
Trenton or Philadelphia
$105k-$130k/yr RemoteFull Time
6+ YOEBachelor's in engineering or construction management (or equivalent experience), 6+ years utility project management experience, strong communication and leadership; PMP preferred.
2mo
Save
Mark Applied
Hide
Senior Project Manager - Utilities (contract)
Baltimore or United States
$75-$85/hr RemoteContract
7+ YOE7+ years project management experience (consulting/agency preferred); utility or highly regulated industry experience required; PMP/CSM/agile preferred; enterprise client experience; proficiency with Azure DevOps, Jira, Confluence, Google Workspace; US citizenship required.
Google Workspace, Azure DevOps, Jira, Confluence