Utilization Manager Jobs in Rhode Island (NOW HIRING)

... HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience, inpatient utilization management review. · MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of ...

Partners with medical staff, case manager, utilization manager, and other members of the healthcare team in collaboration with the patient/family to facilitate the plan of care for patients who are ...

Maintain alignment across stakeholders and manage tradeoffs to keep work focused on highest-value outcomes. * May work on integration and customization of products/platforms, inclusive of AI/agentic ...

Maintain alignment across stakeholders and manage tradeoffs to keep work focused on highest-value outcomes. * May work on integration and customization of products/platforms, inclusive of AI/agentic ...

The Behavioral Health Intake and Utilization Review Coordinator is responsible for bed management, reviewing intake assessments, verifying clinical appropriateness for services, coordinating ...

The Behavioral Health Intake and Utilization Review Coordinator is responsible for bed management, reviewing intake assessments, verifying clinical appropriateness for services, coordinating ...

Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with ...

RN Care Manager The RN Care Manager performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and emergency ...

Job Summary The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and ...

Job Summary The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and ...

Job Summary The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and ...

Job Summary The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and ...

Job Summary The RN Care Manager (RN CM) performs utilization management, case management and discharge planning activities for acute care, and/or extended care patients including ambulatory and ...

Must have prior authorization utilization experience. * Managed Care/Medicare experience preferred. Skills: * MUST HAVE MEDCOMPASS or ASSURECARE exp. * MUST HAVE MANAGED CARE exp and Medicare ...

As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

Collaborate with other DTMs within the region for any dedicated capacity needs to ensure capacity requirements for the branch Asset Utilization * Manage local Transportation team and provide guidance ...

Collaborate with other DTMs within the region for any dedicated capacity needs to ensure capacity requirements for the branch Asset Utilization * Manage local Transportation team and provide guidance ...

Collaborate with other DTMs within the region for any dedicated capacity needs to ensure capacity requirements for the branch Asset Utilization * Manage local Transportation team and provide guidance ...

... utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution Educate offices using approved materials Review patient ...