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.
Regional Director of Utilization Management
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Regional Director of Utilization Management provides strategic and operational leadership for Utilization Management services across an assigned geographic region, ensuring patients receive ...
Regional Director of Utilization Management
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Regional Director of Utilization Management provides strategic and operational leadership for Utilization Management services across an assigned geographic region, ensuring patients receive ...
Regional Director of Utilization Management
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Regional Director of Utilization Management provides strategic and operational leadership for Utilization Management services across an assigned geographic region, ensuring patients receive ...
Regional Director of Utilization Management
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Regional Director of Utilization Management provides strategic and operational leadership for Utilization Management services across an assigned geographic region, ensuring patients receive ...
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization Review Technician II We are seeking a Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization ...
New
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Utilization Review Technician II We are seeking a Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization ...
New
Quality Utilization Reviewer I
Birmingham, AL · On-site
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 ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
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 ...
Utilization Review Technician
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
Utilization Review Technician
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
Quality Utilization Reviewer I
Birmingham, AL · On-site
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 ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
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 ...
Utilization Review Technician
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
Utilization Review Technician
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
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 ...
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
Utilization Review Technician
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
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 ...
New
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 ...
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 ...
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 ...
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 ...
... utilization review. Review admissions and service requests within assigned unit for prospective ... Provide case management and/or consultation for complex cases. Assist departmental staff with ...
... utilization review. Review admissions and service requests within assigned unit for prospective ... Provide case management and/or consultation for complex cases. Assist departmental staff with ...
Manager Utilization Management information
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 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 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 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 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:
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:
What cities in Alabama are hiring for Manager Utilization Management jobs?
Cities in Alabama with the most Manager Utilization Management job openings:
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