Utilization Manager Jobs in Cleveland, OH

Champion the Utilization Management program by leading a team to ensure high-quality service and adherence to clinical guidelines. Collaborate across functions to drive performance, facilitate continu...

Join a dynamic team to advise on network strategy and performance, leading client engagements to enhance provider sustainability and access while leveraging your analytical expertise in diverse market...

Empower health outcomes by overseeing clinical utilization review processes, ensuring accuracy and timeliness while collaborating with providers and payors. Lead the Utilization Review department to m...

Transform daily security operations by managing workflows, incidents, and vulnerability remediation. Collaborate with teams to enhance processes, drive efficient handoffs, and ensure compliance for pr...

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...

Oversee operations for commercial and Medicare care services, implementing policies and protocols to enhance efficiency and compliance with health regulations, while managing a team committed to quali...

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...

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...

Unlock your clinical expertise in a vital non-bedside role, ensuring members receive high-quality care through effective evaluation and collaboration. Engage with healthcare teams to enhance outcomes...

Lead the charge in advancing digital workplace innovations by optimizing collaboration tools and identity management. Drive high-impact initiatives while cultivating a high-performing team to enhance...

Lead the optimization and innovation of enterprise collaboration tools and identity management systems while guiding a team to enhance security and productivity through AI and automation, driving impa...

Optimize IT infrastructure by ensuring high performance and security across on-premises and cloud systems while leading a dedicated team and managing vendor relationships for continuous improvement an...

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...

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

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...

Empower program success by leading quality assurance, compliance, and internal audits. Drive continuous improvement initiatives and ensure all deliverables meet the highest standards in a complex fede...

Champion strategic communications strategies that empower federal clients to effectively convey complex information, driving successful outcomes via collaboration, content creation, and relationship m...

Drive impactful feasibility assessments across clinical studies by evaluating protocols and site capabilities. Collaborate with cross-functional teams to optimize recruitment strategies and ensure dat...

Elevate operational effectiveness as a Regional Manager of Utilization Management, overseeing performance improvement initiatives and compliance across multiple healthcare facilities while collaborati...

Elevate the customer experience by leading implementation projects with our cutting-edge SaaS solutions. Collaborate closely with clients and internal teams to ensure successful adoption and maximizat...

Transform healthcare reimbursement strategies by advising clients on payment reform and financial sustainability. Build trusted relationships and lead teams to develop innovative solutions for Medicai...

Lead and enhance the operations of a high-volume remote call center, driving service excellence and operational efficiency while managing resources and ensuring compliance with performance standards a...

Transform client revenue management by driving performance and resolving issues across $1-$2 million accounts while mentoring staff and ensuring compliance within dynamic healthcare settings...

Join a mission-driven team to shape and enhance operations documentation through the creation and management of high-quality SOPs and governance materials ensuring accuracy, compliance, and accessibil...

Join a team that's driving comprehensive billing variance analysis and resolution during key migration projects. Leverage your Oracle CC&B and CCS/C2M expertise to enhance data integrity, streamline p...