IntusCare is seeking an experienced Utilization Management Manager, an RN who will own the UM program end-to-end for a PACE client. You will oversee a team of UM nurses, ensure policy compliance, and drive continuous improvement in decision
Devoted Health is seeking a Clinical Guide on our Outpatient Utilization Management team. This remote, full-time role focuses on clinical review of outpatient authorization requests using evidence-based criteria and CMS requirements to ensure appropriate care. The ideal candidate
WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care organization that is changing the way clinicians work and live.
UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise Clinical Services. You will collaborate with leadership to implement processes, educate providers, and ensure cost-effective, high-quality care for members. The
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
WellMed, part of Optum, seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements within a collaborative, patient‑focused team across Texas markets. The role emphasizes CMS criteria
WellMed, part of Optum, seeks an experienced physician to join the Utilization Management team as Medical Director. This remote role supports WellMed Medical Management, Inc. with UM determinations and program improvements, aiming to optimize care for seniors nationwide. You’ll
WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care organization that is changing the way clinicians work and live.
WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care organization that is changing the way clinicians work and live.
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
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
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
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
WellMed, part of the Optum family, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current
The Oncology Institute United States Middle All Others 1d ago $144k – $170k About this role Starling Oncology (NASDAQ: STLN) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. Formerly known
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
Devoted Health is seeking a Clinical Guide Part A to support inpatient, behavioral health, and post-acute utilization review in alignment with CMS guidelines. This remote, full-time role requires a licensed RN with several years of UR experience
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
WNS, a Capgemini subsidiary, seeks a licensed RN/LPN for utilization review in a remote U.S.-based role. You will determine medical necessity, support case management, and ensure HIPAA compliance while collaborating with providers and clients. Regular CST schedule applies
JOB DESCRIPTION Job Summary Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends. Responsible for developing