We are recruiting for a mission-driven Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement) to join our team! Were with you for life’s journey. At Denver Health,
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help
Anticipated End Date:2026-08-31 Position Title:Utilization Management Representative I Job Description: Utilization Management Representative I Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life
Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations. You will report to the Manager
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,
Anticipated End Date:2026-09-11 Position Title:Utilization Management Rep III Job Description: Afterhours Utilization Management Representative III Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a
About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industrys first Unified Claims Processing architecture,
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
Team Leader for Utilization Management Healthcare Operations Work Set-up: Onsite - Potential to WFH after training Location: Valero, Makati City Schedule: Graveyard | Shifting Hours Position Summary The Utilization Management Operations Team Leader is responsible for leading the day-to-day operations
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 Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient, behavioral health, and/or post-acute authorization review in alignment with CMS and Medicare Advantage regulations. Reviews
Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help
To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. Job SummaryUtilization Management Nurse performs clinical review of prior approvals, network exceptions, benefit inquiries, inpatient medical/surgical admissions and outpatient procedures for providers,
Hi, were Oscar. Were hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started
Anticipated End Date:2026-09-11 Position Title:Utilization Management Rep II/Clinical Liaison Job Description: Utilization Management Representative II/ Clinical Liaison Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes
Posting number: 2026AL27729 Department: DCHS - Community & Human Srvcs Division: Behavioral Health and Recovery Job classification: Project/Program Manager III (Z3 : KC Personnel Guidelines) Posting type: Open Categories: Mental Health, Project Management, Health Care Support, Career
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
For those who want to invent the future of health care, heres your opportunity. Were going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing