Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer Responsible for the coordination and efficient utilization of health care resources for Cook Childrens Health Plan ...
Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer Responsible for the coordination and efficient utilization of health care resources for Cook Childrens Health Plan ...
UM Coordinator
$23 - $24/hr
UM Coordinator The Quality Management (QM) Coordinator supports daily utilization and quality management operations by assisting with health plan and regulatory audits, coordinating required ...
New
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UM Coordinator
$23 - $24/hr
UM Coordinator The Quality Management (QM) Coordinator supports daily utilization and quality management operations by assisting with health plan and regulatory audits, coordinating required ...
New
Sr. UM Compliance Analyst
Tustin, CA · On-site +1
We're looking for a Sr. UM Compliance Analyst who thrives in a dynamic environment, enjoys solving complex regulatory challenges, and is ready to play a high-visibility role influencing audit ...
Sr. UM Compliance Analyst
Tustin, CA · On-site +1
We're looking for a Sr. UM Compliance Analyst who thrives in a dynamic environment, enjoys solving complex regulatory challenges, and is ready to play a high-visibility role influencing audit ...
Assistant Athletic Trainer, UM Athletics
Missoula, MT · On-site
$55K - $65K/yr
Report any compliance issues to the UM Compliance Office regarding countable athletically-related activities (CARA), student-athlete welfare, or any other applicable NCAA rule and regulation
Assistant Athletic Trainer, UM Athletics
Missoula, MT · On-site
$55K - $65K/yr
Report any compliance issues to the UM Compliance Office regarding countable athletically-related activities (CARA), student-athlete welfare, or any other applicable NCAA rule and regulation
RN UM Saint Johnsbury, VT, United States About the Job RN UM Responsibilities: - Supervise and coordinate the activities of nursing staff in a healthcare setting - Ensure that patient care is ...
RN UM Saint Johnsbury, VT, United States About the Job RN UM Responsibilities: - Supervise and coordinate the activities of nursing staff in a healthcare setting - Ensure that patient care is ...
Sr. UM Compliance Analyst
Tustin, CA · On-site +1
We're looking for a Sr. UM Compliance Analyst who thrives in a dynamic environment, enjoys solving complex regulatory challenges, and is ready to play a high-visibility role influencing audit ...
Sr. UM Compliance Analyst
Tustin, CA · On-site +1
We're looking for a Sr. UM Compliance Analyst who thrives in a dynamic environment, enjoys solving complex regulatory challenges, and is ready to play a high-visibility role influencing audit ...
Senior Analyst, UM Regulatory Operations
Tempe, AZ · Hybrid
$67.81K - $89K/yr
We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations team. Oscar is the first health insurance company built around a full stack technology platform and a ...
Senior Analyst, UM Regulatory Operations
Tempe, AZ · Hybrid
$67.81K - $89K/yr
We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations team. Oscar is the first health insurance company built around a full stack technology platform and a ...
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
Senior Analyst, UM Regulatory Operations
New York, NY · Hybrid
$75.35K - $98.89K/yr
We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations team. Oscar is the first health insurance company built around a full stack technology platform and a ...
Senior Analyst, UM Regulatory Operations
New York, NY · Hybrid
$75.35K - $98.89K/yr
We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations team. Oscar is the first health insurance company built around a full stack technology platform and a ...
RN Supervisor UM Prior Auth
Rancho Cordova, CA · Remote
$53.46 - $79.52/hr
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
RN Supervisor UM Prior Auth
Rancho Cordova, CA · Remote
$53.46 - $79.52/hr
Job Summary and Responsibilities As our Supervisor of Utilization Management (UM), under the guidance and supervision of the department Manager/Director, you will be responsible and accountable for ...
Director UM Management Nurse
OR · Remote
Summary The UM Nurse Lead is responsible for conducting and overseeing clinical utilization management activities to ensure medically appropriate, high-quality, and cost-effective care for members.
Director UM Management Nurse
OR · Remote
Summary The UM Nurse Lead is responsible for conducting and overseeing clinical utilization management activities to ensure medically appropriate, high-quality, and cost-effective care for members.
UM FIRST faculty will also receive both individual and group-based inter-institutional support including mentoring, career advocacy, and guidance within the research enterprise. Through this joint ...
UM FIRST faculty will also receive both individual and group-based inter-institutional support including mentoring, career advocacy, and guidance within the research enterprise. Through this joint ...
Unit Manager (UM) RN
$63K - $63.40K/yr
Unit Manager (UM) (RN) Location: Meadow Wind Health Care Center, Massillon, OH Employment Type: Full-Time About Us Meadow Wind Health Care Center is proud to be recognized as a Great Place to Work ®
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Unit Manager (UM) RN
$63K - $63.40K/yr
Unit Manager (UM) (RN) Location: Meadow Wind Health Care Center, Massillon, OH Employment Type: Full-Time About Us Meadow Wind Health Care Center is proud to be recognized as a Great Place to Work ®
Summary The UM Nurse Lead is responsible for conducting and overseeing clinical utilization management activities to ensure medically appropriate, high-quality, and cost-effective care for members.
Summary The UM Nurse Lead is responsible for conducting and overseeing clinical utilization management activities to ensure medically appropriate, high-quality, and cost-effective care for members.
Sr. Injury Adjuster-UM
San Antonio, TX · On-site +1
$63.59K - $121.53K/yr
The Opportunity As a dedicated Sr. Injury Adjuster- UM , you will be responsible to adjust attorney-involved, moderately complex UM/UIM claims or moderately complex to include confirming coverage ...
Sr. Injury Adjuster-UM
San Antonio, TX · On-site +1
$63.59K - $121.53K/yr
The Opportunity As a dedicated Sr. Injury Adjuster- UM , you will be responsible to adjust attorney-involved, moderately complex UM/UIM claims or moderately complex to include confirming coverage ...
The Division of Continuing and International Education is accepting applications for Part-Time Lecturers for the University of Miami Pre-College program to teach non-credit courses for the UM ...
The Division of Continuing and International Education is accepting applications for Part-Time Lecturers for the University of Miami Pre-College program to teach non-credit courses for the UM ...
Manager, UM Administration
Charleston, SC · On-site +1
The Manager, UM Administration works within specific guidelines and procedures; apply advanced technical knowledge to solve moderately complex problems; receive assignments in the form of goals and ...
Manager, UM Administration
Charleston, SC · On-site +1
The Manager, UM Administration works within specific guidelines and procedures; apply advanced technical knowledge to solve moderately complex problems; receive assignments in the form of goals and ...
The Coordinator, UM Intake at Evolent provides support to the Utilization Management Team. The coordinator will support administrative operations by ensuring the efficient intake, review and ...
The Coordinator, UM Intake at Evolent provides support to the Utilization Management Team. The coordinator will support administrative operations by ensuring the efficient intake, review and ...
Facilities Specialist, UM Campus Dining
Missoula, MT · On-site
$19.45/hr
Non-Exempt Description UM Campus Dining invites applications for a Facilities Specialist to perform custodial work or responsibilities at the Lodge Dining Center. Examples of Duties and ...
Facilities Specialist, UM Campus Dining
Missoula, MT · On-site
$19.45/hr
Non-Exempt Description UM Campus Dining invites applications for a Facilities Specialist to perform custodial work or responsibilities at the Lodge Dining Center. Examples of Duties and ...
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$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
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What are the key skills and qualifications needed to thrive as an Um, and why are they important?
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What is the difference between Um vs Customer Service Representative?
| Aspect | Um | Customer Service Representative |
|---|---|---|
| Required Credentials | High school diploma or equivalent; technical skills | High school diploma; communication skills |
| Work Environment | Call centers, technical support settings | Retail, call centers, online support |
| Industry Usage | Tech, telecommunications, IT | Retail, hospitality, telecom |
| Common Search Intent | Technical support, troubleshooting | Customer inquiries, issue resolution |
Um typically refers to roles focused on technical support or specialized assistance, often requiring technical skills and certifications. Customer Service Representatives handle general customer inquiries and support across various industries. While both roles involve communication, Um roles are more technical, whereas Customer Service Representatives focus on customer relations and problem-solving.

Cook Children's Health Care System rating
7.8
Based on 72 frontline employees who took The Breakroom Quiz
131st of 864 rated healthcare providers
Job description
Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer
Responsible for the coordination and efficient utilization of health care resources for Cook Childrens Health Plan (CCHP) members. Works with the Department Manager and Team Lead to assure the timely provision of quality care throughout the continuum of care. The Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate and fiscally responsible care through communication with the providers and health plan medical directors. The UM/ECM - RN Reviewer assesses and identifies the members clinical information and determines, in conjunction with the Medical Director, medical necessity and appropriateness of requested services. Utilizes Medical Management Committee (MMC) approved clinical criteria to authorize requested services for the member. The UM/ECM - RN Reviewer communicates with providers of care/services to facilitate appropriate care transitions. The UM/ECM - RN Reviewer assures adherence to regulatory/contractually required timeliness standards for authorization request processing, associated communications and notice of adverse determinations are met for CCHP.
Education/Education:
- Associate degree of Nursing required, BSN preferred.
- Minimum of five (5) years clinical experience.
- 2 years utilization management or case management experience required.
Strong skills in the following areas: Oral and written communication; Critical thinking; Organization and time management; Customer service.
Certification/Licensure:
- Current unrestricted Registered Nurse licensure in the State of Texas.
Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.
Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.
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About Cook Children's Health Care System
Sourced by ZipRecruiter
Cook Children's Health Care System, based in Fort Worth, Texas, operates in the healthcare industry with a primary focus on pediatric health services. Established in 1918, the system has been committed to improving the health of children through the prevention and treatment of childhood diseases. This integrated pediatric healthcare system includes a medical center, physician network, home health company, research institute, and a health plan. At the core of its operations is the mission to 'Improve the Health of Every Child' in its community, reflecting its commitment to providing quality care, research, education, and prevention and wellness services.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Fort Worth, TX, US
Year founded
1918