Utilization Manager Jobs in Piscataway, NJ

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...

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...

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...

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...

Join a team focused on improving client network strategies and performance. Leverage your expertise to enhance access, provider sustainability, and utilization management while managing engagements an...

Transform healthcare networks by advising clients on strategy, performance, and sustainability. Leverage data insights and build strong relationships to enhance provider access and value-based outcome...

Inspire positive change by advising clients on network strategy and provider performance. Leverage your expertise to analyze complex data and deliver impactful solutions that enhance healthcare access...

Transform utilization management through strategic leadership, ensuring service access and cost optimization while enhancing clinical outcomes and member satisfaction across various care settings...

Shape the future of patient care by evaluating medical necessity and ensuring compliance in healthcare services. Leverage your nursing expertise to improve quality outcomes while efficiently managing...

Lead the charge in managing complex medical cases to enhance patient outcomes while ensuring cost-effective care delivery across outpatient and inpatient services, all under the guidance of clinical l...

Drive your career with a leadership role overseeing utilization management, ensuring quality and compliance in healthcare services while collaborating with clinical teams to improve patient outcomes a...

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...

Join a team that's dedicated to driving successful outcomes in health projects by managing cross-functional teams and overseeing project deliverables, ensuring innovation and efficiency while fosterin...

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...

Evaluate the medical necessity and appropriateness of healthcare services, ensuring quality outcomes and compliance through effective resource utilization while supporting optimal patient care deliver...

Help us drive customer success through Data 360 & Agentforce by combining technical acumen and commercial strategies. You'll engage with stakeholders to promote platform consumption, fostering growth...

Unlock potential by leading a high-performing Enterprise Account Management team, driving renewal and expansion revenue for key accounts while fostering a culture of strategic engagement and scalable...

Champion clinical excellence as a Medical Director overseeing utilization management. Lead strategic initiatives, integrate interdisciplinary care, and ensure compliance while enhancing member outcome...

Transform vendor management for ancillary benefits, ensuring compliance, quality, and performance excellence while collaborating with teams to enhance member services and operational efficiencies...

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 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...

Partner with us to drive complex enterprise deployments by managing multi-stakeholder programs, aligning teams, and ensuring client satisfaction and swift execution in highly regulated environments...

Execute comprehensive assessments and develop individualized care plans for older adults, ensuring their access to essential services while enhancing health and independence through proactive clinical...

Lead a dynamic IT team to provide top-tier desktop support in Education, Research, and Clinical environments. Ensure efficient technical infrastructure management, direct staff operations, and foster...