Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Utilization Management Nurse
Nashville, TN · On-site
Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Utilization Management Nurse
Nashville, TN · On-site
Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Utilization Management Nurse
Nashville, TN · On-site
Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Utilization Management Nurse
Nashville, TN · On-site
Analyze utilization trends to ensure progress towards organizational goals * Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
Supports leadership in setting department goals, monitoring program effectiveness, and making necessary adjustments based on utilization statistics and cost-benefit analysis. * Leads quality ...
Supports leadership in setting department goals, monitoring program effectiveness, and making necessary adjustments based on utilization statistics and cost-benefit analysis. * Leads quality ...
The Manager of Utilization Review collaborates with leaders throughout the company to support ... Demonstrates strong problem solving and analytical skills. * Demonstrates the ability to ...
The Manager of Utilization Review collaborates with leaders throughout the company to support ... Demonstrates strong problem solving and analytical skills. * Demonstrates the ability to ...
Manager of Utilization Review
Franklin, TN · On-site +1
The Manager of Utilization Review collaborates with leaders throughout the company to support ... Demonstrates strong problem solving and analytical skills. * Demonstrates the ability to ...
Manager of Utilization Review
Franklin, TN · On-site +1
The Manager of Utilization Review collaborates with leaders throughout the company to support ... Demonstrates strong problem solving and analytical skills. * Demonstrates the ability to ...
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 ...
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 ...
Capacity Analyst
Greeneville, TN · On-site
Capacity Analyst GENERAL SUMMARY: The Capacity Analyst is responsible for analyzing, tracking, and ... Track capacity availability, utilization, efficiency, and throughput by asset, line, and department.
Capacity Analyst
Greeneville, TN · On-site
Capacity Analyst GENERAL SUMMARY: The Capacity Analyst is responsible for analyzing, tracking, and ... Track capacity availability, utilization, efficiency, and throughput by asset, line, and department.
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... analyzing and evaluating information; ability to concentrate on tasks and meet deadlines; basic ...
GIS Developer/Analyst. Requisition ID : SAIC CoM 2017 -MC R214157. Client: City of Memphis(State of ... Provide expert utilization of ArcGIS Online technologies to develop applications Provide some ...
GIS Developer/Analyst. Requisition ID : SAIC CoM 2017 -MC R214157. Client: City of Memphis(State of ... Provide expert utilization of ArcGIS Online technologies to develop applications Provide some ...
Space Utilization Planner
$70K - $95K/yr
Overview Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
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Space Utilization Planner
$70K - $95K/yr
Overview Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
Space Utilization Planner
Arnold Air Force Base, TN · On-site
$70K - $95K/yr
Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O-Engineering ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
Space Utilization Planner
Arnold Air Force Base, TN · On-site
$70K - $95K/yr
Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O-Engineering ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
Space Utilization Planner
Arnold Air Force Base, TN · On-site
$70K - $95K/yr
Overview Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
Space Utilization Planner
Arnold Air Force Base, TN · On-site
$70K - $95K/yr
Overview Job Title: Space Utilization Planner Location: Arnold AFB, TN Job Family Code: O ... Analyze interior spaces to maximize functionality, circulation, and user flow * Apply industry ...
SUPPLY CHAIN ANALYST
Knoxville, TN · On-site
Uses clinical utilization and evidence-based practice data to aid in the analyses. * Conducts benchmarking research and analysis, both internally and externally, in support of sourcing and CQVA ...
SUPPLY CHAIN ANALYST
Knoxville, TN · On-site
Uses clinical utilization and evidence-based practice data to aid in the analyses. * Conducts benchmarking research and analysis, both internally and externally, in support of sourcing and CQVA ...
Utilization Analyst information
What jobs make $3,000 a day?
What jobs will boom in 2026?
What is the difference between Utilization Analyst vs Data Analyst?
| Aspect | Utilization Analyst | Data Analyst |
|---|---|---|
| Required Credentials | Bachelor's in healthcare, business, or related field; certifications like CPC or HCISPP | Bachelor's in statistics, computer science, or related field; certifications like CAP or Microsoft Certified Data Analyst |
| Work Environment | Healthcare facilities, insurance companies, or healthcare consulting firms | Various industries including finance, marketing, healthcare, and technology |
| Employer & Industry Usage | Used primarily in healthcare and insurance sectors to optimize resource utilization | Used across multiple industries to analyze data trends and support decision-making |
While both roles involve analyzing data, a Utilization Analyst focuses on healthcare resource management and efficiency, whereas a Data Analyst has a broader scope across industries, analyzing diverse data sets to inform strategic decisions.
What jobs pay 4000 a week without a degree?
What does a utilization analyst do?
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Posted 16 days ago
Job description
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:
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- Conducts prospective, concurrent, and retrospective utilization reviews for medical necessity to ensure treatment and services are appropriate and necessary by reviewing medical records and treatment plans.
- Works collaboratively with healthcare providers and Medical Directors to provide guidance on approvals or requests for health plan determination reviews as applicable utilizing CMS clinical guidelines and insurance policies.
- Maintains accurate and detailed records of reviews, interventions, and communications to ensure adherence to health plan requirements and organizational policies.
- Analyze utilization trends to ensure progress towards organizational goals
- Educates healthcare providers and patients regarding appropriate levels of care and service criteria and guidelines.
- Collaborates with Network and specialists to identify opportunities to educate on value-based care, resolve specialty gaps by markets, improve cost-effectiveness and coordination of care to meet patient needs.
Required Skills/Abilities:
- Strong knowledge of utilization management functions in value-based care, including data analysis, claims review, reimbursement practices, and medical records reviews.
- Thorough, in-depth knowledge of evidence-based practice, legal rules and regulations and best practices in healthcare
- Ability to effectively leverage business and organizational knowledge within and across functional areas
- Must possess a high degree of emotional intelligence and integrity, driven and focused work ethic
- Continuous desire to learn and embrace new methods; ability to adapt and be resilient.
- Self-starter with the ability to think creatively and work effectively
- Ability to build a relationship and work effectively with various seniorities and diverse populations.
- Excellent critical reasoning, decision-making, and problem-solving skills to make informed decisions and ensure effective resource utilization while maintaining quality patient care.
- Willingness and ability to travel, up to 20%
Education and Experience:
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- AA/AS degree in Nursing required; BA/BS degree in Nursing (BSN) or Healthcare Administration preferred
- A valid, active Registered Nurse (RN) license in state(s) of employment required
- A minimum of 3 years’, current direct utilization management requiredÂ
- Work in an acute care facility, community-based clinic, public health department or specialization with the senior population preferred
- Proficient PC skills
- Fluency in Spanish or other languages spoken by people in the communities we serve is desirable, but not required
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.