Remote Director, Utilization Management - Long-Term Care
Centene Corporation
Centene is seeking a Director of Utilization Management in a remote-capable role based in Florida. You will lead the utilization management team to ensure policies are applied for optimal member outcomes, with emphasis on Long-Term Care UM and NCQA standards. The role requires 7+ years of experience with prior management, a Bachelor's degree, and RN licensure is preferred. Competitive pay and flexible work options are offered. #J-18808-Ljbffr
- ...Centene is seeking a Director of Utilization Management in a remote-capable role based in Florida. You will lead the utilization management team to ensure... ...for optimal member outcomes, with emphasis on Long-Term Care UM and NCQA standards. The role requires 7+ years...Remote workFlexible hours
$101.72k - $198.36k
...Location: California - Ability to work remote, but selected candidate must reside... ...or all of the following functions: utilization management, care management, behavioral health and other... ...management, care transitions, long-term supports and services (LTSS), behavioral...Remote workContract workWork experience placementWork at officeLocal area$112.7k - $193.2k
...Utilization Management DirectorExplore opportunities with Kelsey-Seybold Clinic, part of the Optum... ...with one of the nation's leading health care organizations and build your career at... ...and non-clinical operations. The Director is accountable for ensuring all Utilization...Remote workMinimum wageFull timeContract workWork experience placementLocal area- ...Director Transformers, T&D Hardware & Utility Remote, Nationwide A fast-moving infrastructure supply organization... ..., and the chance to build long-term customer partnerships across some... ...procurement teams, estimators, project managers, and executive stakeholders to...Remote workFor contractors
$150k - $200k
...for the Southeastern US Director – Utility Substations About the... ...Lakewood, Colorado) and full-time remote candidates. Essential... ...Resource Allocation and Management ~ Develops appropriate team... ...equipment, etc.) ~ Dependent Care Match ‘Atwell’ness:...Remote workFull timeWork at officeLocal area$160k
...Integra’s Utilization Management (UM) division is looking for an experienced... ...teams for a managed care organization. This... ...with Chief Medical Director to establish, adopt, and... ...Company-paid short term disability coverage (location... ...opportunities Remote Opportunities We are actively...Remote workTemporary workLocal areaFlexible hours- ...Humana is seeking a dedicated Utilization Management Registered Nurse to interpret and support clinical and administrative determinations for post-acute care services including SNF, Home Health, and DME. You will work from home or hybrid, reporting to the Manager of...Remote workWork from home
$133.7k - $247.4k
...Position Purpose: Directs the long-term care of members with physical/... ...objectives within long-term care management to improve member and/or... ...Health Plan: Resource Utilization Group (RUG) certification must... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timeContract workPart timeWork at officeFlexible hours$121.5k - $224.9k
About This Role The Director of Utilization Management directs the utilization management team to ensure... ...experience and a strong background in Long-Term Care Utilization Management. Highlights... ...$121,500 - $224,900/year Location: Remote, FL Brand/Division: Centene...Remote workFull timeWork at officeFlexible hours- ...US Ignite, Inc. in Washington, DC, seeks a Technical Program Manager, Smart Utilities to lead utility modernization projects across military bases and commercial applications. You will guide the delivery of electric, gas, and water utility solutions and help expand...Remote work
- ## Associate Dental Director, Government Programs Dental Consulting and Utilization ManagementApply: This is... ...position, both in-office and remote.: Okemos, MI: Detroit,... ...and Utilization Management**Number of Positions:*... ..., quality-of-care reviews, peer-to-peer...Remote workFull timeWork at office
- ...Arkansas Blue Cross and Blue Shield is seeking an RN Utilization Management Nurse to perform clinical reviews for medical necessity across various services. The role involves weekend coverage and work from home within Arkansas and several western states. The ideal...Remote workWork from homeWeekend work
- ...Cambia Health Solutions is seeking an Utilization Management Nurse to support care decisions for members across Oregon, Washington, Idaho, and Utah. You’ll review medical necessity, apply evidence-based criteria, and work with physicians and care teams to optimize outcomes...Remote workWork from homeFlexible hours
- ...CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare services. Join a dynamic...Remote workWork from home
$134.6k - $230.8k
...is a global organization that delivers care, aided by technology to help millions... ...training and quality organization supporting utilization management operations across a large,... ....You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area- ...OptumCare's Kelsey-Seybold Clinics in Houston area seeks a Director of Utilization Management (RN) to provide executive oversight across inpatient and... ...requires a Texas RN license and 10+ years in managed care with 5+ in leadership, plus strong regulatory analysis experience...
- ...Health is seeking an experienced Registered Nurse to support utilization management from a remote home-based setting across the United States. The role involves assessing patient needs, planning and coordinating care, and collaborating with providers to render coverage...Remote jobWork from homeWeekend work
- ...Gainwell Technologies LLC is seeking an Associate Manager, Clinical Quality to lead QA for Prior Authorization reviews.... ...RN license, strong leadership skills, and 5+ years in PA/utilization management. This remote US role offers growth opportunities and a comprehensive...Remote work
$161k - $221.75k
...experienced Associate Director, Clinical... ...open to considering remote candidates with the... ...agreementsMatrix manage biomarker assay development... ...approach utilizing a combination of factors... ...both short term and long-term incentives, including... ...in our mission. Caring Deeply. Achieving...Remote workFull timeContract workTemporary workLocal area- ...Find your calling at Mercy! Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial...Remote workFull time
- ...intensive, individualized case management and support as needed... ...resident. The Nurse Care Manager is a key member... ...and safely for as long as possible by developing... ...appropriate referrals. Utilize collected data to identify... ...in Spanish required Remote Type: On-site Salary...Remote workFlexible hours
$29 - $62 per hour
About This Role The Utilization Management Nurse Consultant role at CVS Health involves utilizing clinical... ...with a strong background in acute care and a passion for improving healthcare... ...Highlights Pay: $29 - $62/hour Location: Remote, TX Residency: Must reside in EST or...Remote workWork at officeWork from homeAfternoon shift- ...University is seeking an Assistant to the Director, Utilities Production, on the Ithaca campus. You will support the Director, Plant Managers, and staff, overseeing office operations... ...days onsite onboarding, with on‑campus 4 days/week and 1 day remotely. #J-18808-LjbffrRemote workWork at office
$60.2k - $107.4k
...Utilization Management NurseAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing... ...to the Health Plan Medical Director for review and decision making... ...have the flexibility to work remotely as you take on some tough...Remote workMinimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday$173.28k - $209.98k
...failures around Facilities & Utilities. Lead and author high-... ...equipment lifecycle management Provide oversight of... ...Subject to the terms and conditions of the... ...design, field-based and remote-by-design. The model assigned... ...R1607446 : Associate Director, Aseptic Facility and...Remote workHourly paySummer workLive inLocal areaFlexible hours$160k - $180k
...Consulting; Infrastructure; Utility Services; Environmental Health... ...Sciences; Buildings & Program Management; and Geospatial Technology.... ...lifecycle material sourcing, remote logistics, and final delivery... .... This policy applies to all terms and conditions of employment,...Remote workContract workSeasonal workWork at officeLocal area$29.1 - $62.32 per hour
...by passionate colleagues who care deeply, innovate with... ...and one community at a time. Utilization Management Nurse Consultant Clinical Precertification... ...RN (Medicare Home Care) Remote | Full-Time | Weekday... ...bonus, commission or short-term incentive program in addition...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeMonday to FridayAfternoon shiftWeekday work- ...HealthEdge in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity reviews across... ...and 1+ year in Behavioral Health/utilization management; remote work across time zones as #J-18808-LjbffrRemote work
- ...nursing facilities healthcare staffing long-term care post-acute care pulmonary care... ...at leading through multiple layers of management, improving operational processes, and... ...are desirable. The role is full-time and remote, with a requirement for monthly travel...Remote workFull time
- ...Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote work
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