Utilization management Jobs

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QI Nurse Specialist (RN) (Utilization Management)

CalOptima

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Remote

Full-time

QI Nurse Specialist (RN) (Utilization Management) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (RN) (Utilization Management) to join our team. The Quality Improvement (QI) Nurse Specialist for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's direct network and delegated Health Network teams. The incumbent will be responsible for ensuring standards are met for operational and oversight compliance and UM operations a
Posted 2 days ago

Senior Project Solution Manager (Utilization Management) - Remote

Prime Therapeutics, LLC

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Remote or Washington, District of Columbia, USA

Full-time

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting Title Senior Project Solution Manager (Utilization Management) - Remote Job Description Summary Responsible for the management of a variety of projects for corporate and/or strategic business unit (SBU). Provides support through the planning and execution of these projects. Support may include establishing de
Posted 20 days ago | Updated 1 hour ago

Healthcare Revenue Cycle Management - Managing Consultant - Utilization Management/Utilization Review

Navigant Consulting

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Remote

Full-time

Job Family : Finance & Accounting Consulting Travel Required : Up to 75%+ Clearance Required : None What You Will Do : Managing Consultants own client engagements from cultivation to completion. In this role, you will be accountable for the activities of the project team and support the day-to-day management of the client relationship. You are expected to effectively develop and manage work plans, staffing, deadlines and budgets for multiple complex projects simultaneously. Work products are