Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day Shift, 7am- 3:30pm, Monday- Sunday every other week after completion of orientation. Summary: The UR ...
In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day Shift, 7am- 3:30pm, Monday- Sunday every other week after completion of orientation. Summary: The UR ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day Shift, 7am- 3:30pm, Monday- Sunday every other week after completion of orientation. Summary: The UR ...
In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day Shift, 7am- 3:30pm, Monday- Sunday every other week after completion of orientation. Summary: The UR ...
Identifies and reports Quality and Risk Management concerns. DCH Standards * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
Identifies and reports Quality and Risk Management concerns. DCH Standards * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Performs utilization review and case management support on complex members * Provides support over the phone, through messaging and video to support chronic disease management * Offers peer-to-peer ...
Performs utilization review and case management support on complex members * Provides support over the phone, through messaging and video to support chronic disease management * Offers peer-to-peer ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Overview Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is ...
Overview Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is ...
... Utilization Review position requiring a CA RN license, BSN, and prior teaching hospital experience ... manager at time of offer, with no additional requests accepted mid-contract and none within the ...
... Utilization Review position requiring a CA RN license, BSN, and prior teaching hospital experience ... manager at time of offer, with no additional requests accepted mid-contract and none within the ...
American Traveler is hiring a Travel RN Case Manager for a hospital setting requiring 1+ year of recent case management/utilization review experience and an active FL or compact RN license. Job ...
American Traveler is hiring a Travel RN Case Manager for a hospital setting requiring 1+ year of recent case management/utilization review experience and an active FL or compact RN license. Job ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Three years experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit with excellent communication ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not ...
Manager Utilization Management information
What does a manager utilization management do?
A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the key skills and qualifications needed to thrive as a manager utilization management?
To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.
What are some common challenges faced by a manager utilization management, and how can they effectively address them?
Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.
What is the difference between Manager Utilization Management vs Utilization Review Nurse?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.
What are the most commonly searched types of Utilization Management jobs in Alabama?
The most popular types of Utilization Management jobs in Alabama are:
What are popular job titles related to Manager Utilization Management jobs in Alabama?
For Manager Utilization Management jobs in Alabama, the most frequently searched job titles are:
- Utilization Review Physician
- Non Exempt No Experience Utilization Management Nurse
- Remote Utilization Management
- Utilization Management Nurse
- Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- Flex Schedule Remote Utilization Review Nurse
- Manager Care Management
- Registered Nurse Utilization Review
- Remote Utilization Review Rn
What job categories do people searching Manager Utilization Management jobs in Alabama look for?
The top searched job categories for Manager Utilization Management jobs in Alabama are:
- Fulltime Cigna Utilization Review Nurse
- Utilization Review Case Manager
- Locum Medical Utilization Review Physician
- Nurse Practitioner Utilization Review
- Remote Cigna Utilization Review Nurse
- Rn Utilization Review Nurse
- Registered Nurse Case Review
- Online Utilization Review
- Flex Schedule Utilization Review
- Authorization Utilization Review Bcba
What cities in Alabama are hiring for Manager Utilization Management jobs?
Cities in Alabama with the most Manager Utilization Management job openings:
Utilization Management Nurse
Birmingham, AL • On-site
Blue Eagle Consulting (BEC)
• IT Services • 11 - 50 employees11 - 50 employees
Full-time
Re-posted 6 days ago
Job description
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
About Blue Eagle Consulting
Sourced by ZipRecruiter
Industry
It services
Company size
11 - 50 Employees
Headquarters location
Birmingham, AL, US
Year founded
2004