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Chief Medical Officer
Southeast Health

Dothan, Alabama

Northern Light Health Logo
Physician and Wound Healing Medical Director
Northern Light Health

Portland, Maine

Featured! NEW!
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Manager, Avondale Emergency Department
Phoenix Children's

Phoenix, Arizona

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Chair, Department of Radiology - CentraState Medical Center, Freehold NJ
Atlantic Health

Freehold, New Jersey

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University of Minnesota Physicians Logo
Physician for Division Director - Pediatric Genetics & Metabolism - (Assistant, Associate & Professor - Academic Track or Assistant Professor - Tenured Track)
University of Minnesota Physicians

Minneapolis, Minnesota

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RN - Registered Nurse - Ophthalmology
Geisinger

Danville, Pennsylvania

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Manager - Post Life Services
Labcorp

Madison, Wisconsin

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RN- Registered Nurse- Advanced Acute Care Cardiac Telemetry Unit
Geisinger

Wilkes-Barre, Pennsylvania

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Sr Project Manager
BJC HealthCare

Saint Louis, Missouri

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Assistant Nurse Manager Operating Room
BJC HealthCare

Saint Louis, Missouri

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RN Registered Nurse Care Manager - Care Coordination HSH
Penn State Health

Camp HIll, Pennsylvania

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RN - Registered Nurse - Advanced Acute Care Medical and Oncology Unit
Geisinger

Scranton, Pennsylvania

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Penn State Health Logo
Program Director ? Nursing Quality and Safety
Penn State Health

Hershey, Pennsylvania

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Assistant Nurse Manager ANM - Cognitive Health CHU - FT Varies
Northeast Georgia Health System

Gainesville, Georgia

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CHRISTUS Health Logo
Clinical Nurse Manager (RN) Critical Care / Full-time
CHRISTUS Health

Santa Fe, New Mexico

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RN Registered Nurse Case Manager
BJC HealthCare

Florissant, Missouri

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Executive Assistant-BJC Med Group
BJC HealthCare

Saint Louis, Missouri

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Manager-Talent Acquisition
Indiana University Health

Indianapolis, Indiana

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High-Risk Cardiology - Assistant Nurse Manager (Day Shift)
BJC HealthCare

Saint Louis, Missouri

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Denver Health Logo
Medical Director, Adolescent Inpatient Psychiatry Unit and Substance Use Disorder Medical Management Service
Denver Health

Denver, Colorado

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Medstaff Affairs Manager
BJC HealthCare

Saint Louis, Missouri

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Sr. Manager Performance Improvement Program Management
BJC HealthCare

Saint Louis, Missouri

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Assistant Nurse Manager TCU
BJC HealthCare

Saint Louis, Missouri

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Assistant Nurse Manager LDRP
BJC HealthCare

Shiloh, Illinois

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Manager Patient Logistics - Patient Logistics
Penn State Health

Hershey, Pennsylvania

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Utilization Management Specialist
DescriptionUnder the direction and supervision of the Utilization Management Manager, the Utilization Management Specialist is responsible for overseeing the research, resolution and workflow development of out-of-network (OON) referral requests. This role reviews OON referral requests from members and providers, acting as a key liaison to facilitate timely, accurate, and efficient processing. In addition, the UM Specialist will:Ensure compliance with organizational guidelines and regulatory standards, promoting quality care access for members while optimizing network utilization and reducing unnecessary out-of-network expenses


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