Utilization Manager Jobs in Miami, FL

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...

Shape the future of healthcare by overseeing efficient utilization management processes, ensuring quality care delivery while managing costs, and leading a dedicated team to uphold industry standards...

Shape healthcare delivery by leading the Utilization Management team, refining practices and policies to optimize resources and member outcomes while ensuring compliance and excellence in care...

Transform healthcare by coordinating services across various medical professionals, ensuring quality care and optimal resource utilization to achieve member wellness and outcomes...

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...

Oversee complex, multi-phase enterprise implementations in the public safety sector. Manage relationships, delivery quality, and timelines while leveraging AI tools to enhance program execution and st...

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...

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...

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 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...

Lead revenue cycle operations across multiple medical centers, ensuring compliance, financial integrity, and optimized claims resolution. Collaborate with cross-functional teams to enhance charge capt...

Join a team that's dedicated to advancing patient care and operational excellence. You will oversee medical programs, manage staff, ensure compliance, and coordinate services, all while fostering a cu...

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...

Develop and lead comprehensive Revenue Cycle Management, overseeing the entire billing process, vendor contracts, and risk adjustment, while collaborating with Clinical, Finance, and Data teams for op...

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

Unlock innovative SAP-based Finance Transformation projects to drive client success. Collaborate with senior executives, develop transformative solutions, and lead project teams to enhance operational...

Manage business office operations at skilled nursing facilities, ensuring financial accuracy and operational efficiency while complying with regulatory standards to support organizational goals and en...

Engage in critical clinical reviews to ensure compliance with medical necessity criteria, collaborate with providers, and contribute to quality improvement initiatives while fostering timely member ca...