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BJC HealthCare Logo
Patient Safety and Risk Management Specialist
BJC HealthCare

Saint Louis, Missouri

NEW!
AdventHealth Logo
PFS Director Home Care Remote
AdventHealth

Altamonte Springs, Florida

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CHRISTUS Health Logo
Manager Compliance - Good Shepherd Medical Center
CHRISTUS Health

Longview, Texas

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Kindred Hospitals Logo
RN Case Manager Full Time
Kindred Hospitals

Seattle, Washington

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UCLA Logo
Accounts Payable Manager (Hybrid)
UCLA

Los Angeles, California

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Mercy Logo
Physician - Medical Director of Emergency Medicine - Mercy Hospital Jefferson - Festus, Missouri
Mercy

Festus, Missouri

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Duke University Health System Logo
Nurse Manager, AC-Duke Primary Care-Wellesley
Duke University Health System

Cary, North Carolina

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Vanderbilt Health Logo
Assistant Director - West TN Hybrid
Vanderbilt Health

Nashville, Tennessee

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BJC HealthCare Logo
Assistant Nurse Manager Inpatient Psych Delmar Campus
BJC HealthCare

Saint Louis, Missouri

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AdventHealth Logo
Clinical Operations Manager Physical Therapist
AdventHealth

Davenport, Florida

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Veterans Affairs, Veterans Health Administration Logo
Physician - Section Chief Nuclear Medicine
Veterans Affairs, Veterans Health Administration

East Orange, New Jersey

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UCLA Logo
Manager - Clinical Engineering
UCLA

Santa Monica, California

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UCLA Logo
RN, Case Manager (Career) - UCLA West Valley Medical Center
UCLA

West Hills, California

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UNC Health Logo
Portfolio Manager- Rex Health Ventures
UNC Health

Raleigh, North Carolina

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AdventHealth Logo
Assistant Nurse Manager Neuro ICU FT Nights
AdventHealth

Orlando, Florida

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CHRISTUS Health Logo
Registered Nurse Program Manager Salary-Cardiology Cath-Full Time
CHRISTUS Health

Shreveport, Louisiana

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WakeMed Health & Hospitals Logo
Financial Management Analyst, Financial Planning
WakeMed Health & Hospitals

Raleigh, North Carolina

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AdventHealth Logo
Registered Nurse RN Care Manager
AdventHealth

Orlando, Florida

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St. Francis-Emory Healthcare Logo
Discharge Planner- Case Management
St. Francis-Emory Healthcare

Columbus, Georgia

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Mercy Logo
Physician - Medical Director - Hospital at Home - St. Louis, MO
Mercy

Chesterfield, Missouri

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CHRISTUS Health Logo
Case Manager Case Management/Per Diem
CHRISTUS Health

Santa Fe, New Mexico

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Geisinger Logo
Interventional Cardiology
Geisinger

Danville, Pennsylvania

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AdventHealth Logo
Case Manager Registered Nurse
AdventHealth

Eustis, Florida

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Veterans Affairs, Veterans Health Administration Logo
Physician (Chief of Surgery)
Veterans Affairs, Veterans Health Administration

Martinsburg, West Virginia

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Nicklaus Children’s Health System Logo
RN Director of Clinical/Quality Ops (Full Time,Day shift)
Nicklaus Children’s Health System

Miami, Florida

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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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