Utilization Manager Jobs

Transform patient care by conducting utilization reviews to ensure compliance with medical necessity and regulatory standards, while collaborating with treatment teams to streamline processes and impr...

Transform cell therapy operations through effective scheduling, continuous improvement, and team leadership. Drive efficiency by developing operational systems and collaborating cross-functionally to...

Lead the charge in enhancing patient care through strategic oversight of Utilization Management. Oversee interdisciplinary collaboration, ensure compliance, and implement effective systems to improve...

Lead the Utilization Management team, overseeing operations for inpatient, outpatient, and long-term services. Innovate programs for quality and cost-effectiveness while ensuring compliance with regul...

Transform patient care by leading utilization management efforts, ensuring accurate status determinations and compliance with regulations. Collaborate with healthcare teams to optimize patient outcome...

Drive operational excellence by leading a team of patient navigators in managing non-clinical services for high-risk populations, ensuring seamless care transitions and effective service delivery in a...

Oversee the daily operations of non-clinical patient navigation services, ensuring efficient workflows, timely access to care, and high-quality service delivery while leading a team to support high-ri...

Join us to lead our clinical review team in ensuring optimal care for NICU members through effective utilization management. Drive process improvements and support day-to-day operations while fosterin...

Lead the charge in optimizing patient care and efficient utilization management, ensuring seamless collaboration between interdisciplinary teams and timely reviews for quality and compliance from admi...

Champion coordinated care by leveraging clinical nursing expertise to facilitate medical service determinations, ensuring optimal post-acute support for members. Collaborate with providers for effecti...

Shape the future of healthcare utilization management and quality assurance! Collaborate with a multidisciplinary team to optimize patient care, enhance discharge planning, and ensure best practices f...

Transform inpatient utilization management by leading a strategic team that enhances member engagement, optimizes quality care, and streamlines health resources in accordance with regulatory standards...

Unlock your potential in a vital operations role that enhances client care coordination, ensures timely execution, and fosters meaningful communication with clients and families, all while supporting...

Lead the charge in optimizing patient care access by managing pre-authorization requests and concurrent reviews, combining clinical expertise and relationship management to streamline processes and en...

Transform the clinical review landscape by managing complex utilization reviews across diverse lines of business, ensuring compliance, quality, and efficiency, while being a key resource for peers and...

Empower the healthcare landscape by managing complex utilization reviews across diverse lines of business, ensuring compliance, quality, and efficiency in clinical practices while providing expert gui...

Optimize clinical review processes by managing complex utilization assessments, ensuring compliance, guiding peers, and enhancing service efficiency—all while maintaining accountability and supporting...

Elevate clinical excellence by leading complex utilization reviews, ensuring compliance and efficiency across multiple lines of business while fostering high-quality patient care and continual process...

Champion clinical excellence by independently managing complex utilization reviews, ensuring compliance, and uplifting quality across various healthcare services while collaborating with teams to driv...

Innovate in clinical utilization management by evaluating treatment efficacy, guiding peers in compliance, and leading quality initiatives to enhance service delivery across multiple business lines wi...

Reimagine care delivery by independently managing complex utilization reviews, evaluating compliance, and enhancing clinical efficiency to ensure quality and cost-effective services across multiple li...

Empower your career by managing complex utilization reviews and ensuring effective clinical oversight. Collaborate on process improvement initiatives while providing valuable support to peers in a dyn...

Execute essential analyses and optimize workflows in Epic systems to enhance operational efficiency. Collaborate across teams, streamline processes, and ensure compliance while supporting the Utilizat...

Collaborate with clients to optimize network strategies, enhance provider performance, and address utilization challenges in complex healthcare environments. Leverage data insights to drive recommenda...

Analyze network strategy and provider performance to enhance client outcomes. Leverage expertise in Medicaid environments to advise on access, utilization, and network design while managing engagement...