NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we
Job Description The Role GM continues to enhance its Digital Retail Platform (DRP), which provides an omnichannel learning, shopping, and buying experience for all GM brands. The platform enables customers to buy or lease their next
About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and
Job Purpose The Project Manager, Utilization Review provides operational and analytical support to Physician Advisory end-to-end clients. The Project Manager, Utilization Review will oversee implementation coordination, stakeholder management, utilization data analysis Duties & Responsibilities • Prepare and participate in client review
About IntusCare: IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual
JOB SUMMARY The Operations Manager drives Dane Street’s Group Health division by aligning daily operational leadership with clinical excellence in a high-volume, fast-paced environment. This role exists to ensure the seamless execution of utilization and independent clinical reviews
Job Summary: The Utilization Management (UM) Market Operations Manager is responsible for the operational activities of UM and Appeals for a specified line(s) of business managing the development of policies and procedures, review of team metrics, statutory reporting,
Overview Are you a licensed RN who is interested in using your clinical expertise outside of a clinical or hospital setting? Do you pride yourself in examining all the details of a situation before making important
Job Title Utilization Workflow Manager LocationRemote/Nationwide, USA Additional Location(s) Employee TypeEmployee Working Hours Per Week40 Job Description OASIS & coding experience strongly preferred. Compensation: $70,000.00 - $90,000.00 The base compensation range for this role is fixed, with a
Case Manager, RN- Utilization Review - (260002ZT) Description Under the general supervision of the Utilization Management Manager and in accordance with established policies, professional guidelines, and CMS Conditions of Participation for Utilization Review, the Utilization Management Nurse (UMN) ensures patients are assigned
Job Summary: The Manager, Utilization Management is responsible for the oversight of all utilization management activities ensuring consistency of services and achievement of utilization targets. Essential Functions: Assist in coordination and management of the pre-determination process of medical and dental
Care Manager RN - REMOTE position. This position is Full time and will work 8- hour, Day shifts. The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence
Position Purpose: Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and facilitates operations within utilization management. This
Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we
Quartz is seeking a Utilization Management RN Case Manager to review prior authorization requests, coordinate transitions back to in-network services, and collaborate with physicians, hospital case managers, home health, and SNF staff to ensure optimal patient care. The role
UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure appropriate utilization of health services and coordinate plans of care. This role offers remote work and requires strong clinical nursing experience and an RN license. You
UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and coordinate plans of care. This role supports remote work within the Pacific, Mountain, or Central Time Zones and partners with
UnitedHealth Group is seeking an Inpatient Care Management Nurse to join our remote-first team. You will assess patient needs, apply evidence-based criteria, and coordinate care across facilities, discharge planning, and downstream partners. Qualifications include an active
UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services. You will assess member needs, interpret requirements, and collaborate with healthcare professionals to plan care and discharge efficiently. You will work
BeOne continues to grow at a rapid pace with challenging and exciting opportunities for experienced professionals. When considering candidates, we look for scientific and business professionals who are highly motivated, collaborative, and most importantly, share our