Utilization Manager Remote Jobs

Shape the future of healthcare by leading our nationwide Post-Acute Care Utilization Management team, ensuring compliance and optimal member outcomes through strategic oversight and team development...

Champion operational excellence by supervising daily Utilization Management (UM) operations. Lead teams in achieving contract metrics while ensuring quality clinical care and compliance with accredita...

Lead the charge in designing and delivering configuration solutions that enhance healthcare payer operations, collaborating across teams to optimize the Facets platform and drive successful implementa...

Join a team that's dedicated to enhancing healthcare outcomes through strategic leadership in hospice and palliative care management, ensuring compliance and operational excellence across Medicaid and...

Take ownership of a high-performing remote customer service team, ensuring operational excellence and employee development while fostering a positive, inclusive culture. Lead strategic improvements to...

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

Innovate in product strategy by defining value propositions, aligning stakeholders, and overseeing execution. Engage in sprint reviews to optimize performance and drive value across product portfolios...

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...

Empower data management excellence by overseeing sensitive data governance, security, and analysis efforts. Collaborate with cross-functional teams while ensuring compliance and integrity in a secure...

Take ownership of commercial performance and strategy for a crucial product portfolio. Lead cross-functional teams to drive growth, define market positioning, and influence product direction, ensuring...

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...

Lead the charge in implementing innovative TMS solutions at client sites, ensuring seamless transitions and effective training for users. Collaborate across teams to tailor strategies and provide real...

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 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...

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...

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...

Unlock potential by leading client analytics setups to create impactful reporting for health systems, enhancing revenue cycle efficiency through data processes, and driving implementation improvements...

Drive quality outcomes by reviewing medical records for compliance and reimbursement. Collaborate with clinical teams and external agencies to evaluate care levels and ensure adherence to established...