Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
New
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
New
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
New
Nashville, TN · On-site
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
New
Nashville, TN · On-site
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
New
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory surgery, and Point-of-Entry Utilization review/case management activities. This role is crucial in ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory surgery, and Point-of-Entry Utilization review/case management activities. This role is crucial in ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory surgery, and Point-of-Entry Utilization review/case management activities. This role is crucial in ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory surgery, and Point-of-Entry Utilization review/case management activities. This role is crucial in ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
Cookeville, TN · On-site
The Utilization Management Manager is responsible for overseeing the organization's utilization review functions to ensure appropriate, cost-effective use of healthcare services. This role leads a ...
Cookeville, TN · On-site
The Utilization Management Manager is responsible for overseeing the organization's utilization review functions to ensure appropriate, cost-effective use of healthcare services. This role leads a ...
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Maintain utilization management databases and spreadsheets. * Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee. * Communicate ...
New
Franklin, TN · On-site +1
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
Franklin, TN · On-site +1
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
Franklin, TN · On-site
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
Franklin, TN · On-site
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
Burns, TN · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Burns, TN · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
$35.4K - $46K
9% of jobs
$53.8K is the 25th percentile. Wages below this are outliers.
$46K - $56.6K
22% of jobs
$56.6K - $67.2K
11% of jobs
The median wage is $73.7K / yr.
$67.2K - $77.8K
14% of jobs
$77.8K - $88.4K
12% of jobs
$95K is the 75th percentile. Wages above this are outliers.
$88.4K - $99K
13% of jobs
$99K - $109.6K
13% of jobs
$109.6K - $120.2K
5% of jobs
$120.2K - $130.8K
2% of jobs
$130.8K - $141.4K
0% of jobs
$141.4K - $152K
0% of jobs
$35.4K
$82.6K
$152K
| 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.

Other
Posted 6 days ago
New
Job Summary:
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating medical services, treatments, and procedures. This role identifies trends for opportunities to educate and collaborate with healthcare providers, patients, and specialists to optimize resource utilization and improve patient outcomes.
Duties/Responsibilities:
Â
Required Skills/Abilities:
Education and Experience:
Â
ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.