Utilization Manager Remote Jobs

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...

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...

Contribute to a high-performing clinical review team by supervising utilization management operations, resolving complex care issues, ensuring compliance with standards, and driving quality improvemen...

Contribute to the success of multiple clinical research sites by leading operations, ensuring compliance with regulations, and fostering team development to enhance patient care and operational excell...

Analyze and optimize the quality of patient care through clinical reviews, ensuring effective utilization of resources while adhering to established guidelines and policies...

Engage in transformative leadership in Utilization Management Operations, driving clinical excellence and scalable business processes. Oversee a dynamic team and vendor partnerships while leveraging t...

Lead a tax account management team focused on delivering exceptional customer service, driving operational excellence, and fostering strategic relationships in a dynamic service environment...

Unlock the potential of healthcare management by leading efforts to enhance quality and utilization standards, fostering collaboration between providers and ensuring optimal health outcomes for member...

Lead the Utilization Management team in ensuring high-quality healthcare delivery. Oversee provider engagement and compliance with standards, fostering collaboration with physicians and hospitals to e...

Lead the charge in Utilization Management by reviewing inpatient, behavioral health, and post-acute services to ensure compliance with CMS and Medicare Advantage standards while evaluating medical nec...

Join a team that's transforming healthcare delivery by ensuring members receive timely and appropriate care through effective Utilization Management practices, collaborating with diverse teams and imp...

Lead the charge in delivering efficient utilization management services by leveraging clinical expertise to assess and coordinate appropriate healthcare options for members, while ensuring compliance...

Transform healthcare delivery by utilizing clinical expertise in a collaborative environment to assess and facilitate optimal member services and care options while monitoring quality and compliance i...

Transform project delivery by leading and mentoring a team of Project Managers, ensuring high-quality execution of complex software implementations while maintaining customer satisfaction and driving...

Join a team that's pivotal in ensuring accurate client payment policies. You'll manage medical policy integrity while conducting research and analysis, collaborating with internal teams, and providing...

Drive end-to-end contingent workforce operations, enhancing client satisfaction and managing relationships with stakeholders. Leverage your staffing experience to elevate program success and explore n...

Unlock potential by driving business development efforts in strategic markets, collaborating with leadership and teams to enhance client relationships and marketing initiatives. Utilize expertise in t...

Grow your career with a focus on business development, driving revenue and profit growth through strategic client partnerships and innovative marketing initiatives in the power/energy sector...

Join a dynamic team as you manage renewals, develop strategies, and foster relationships with brokers to ensure timely, accurate, and customer-focused renewal experiences while driving retention and o...

Drive optimal member care by leveraging clinical expertise and collaboration. Analyze utilization trends while advising leadership to ensure compliance with Medicare and state regulations, leading eff...

Join a team that leads the behavioral health utilization review process, ensuring high-quality care for members while managing a skilled team. Play a crucial role in compliance, performance monitoring...

Transform integrated care delivery for complex populations as a strategic senior leader. Oversee national Complex Care Management and Utilization Management programs to improve health outcomes, ensure...

Take ownership of drug utilization management by leading reviews, ensuring compliance, and collaborating with stakeholders. Enhance pharmacy operations through expertise and trend analysis, impacting...

Lead the charge in optimizing utilization management processes to ensure operational efficiency and high-quality patient care. Supervise a dedicated team, ensuring compliance and satisfaction across h...

Transform project delivery by leading complex initiatives, ensuring collaboration across teams, monitoring timelines and budgets, and maintaining clear communication with stakeholders for successful o...