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
$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
...with one of the nation's leading health care organizations and build your career at... ...operational oversight for all Utilization Management functions, including inpatient utilization... ...clinical and non‑clinical operations. The Director is accountable for ensuring all...Remote workMinimum wageFull timeContract workWork experience placementLocal area- ...Centene Corp. seeks a Director of Utilization Management remote in Florida to lead the UM team, ensuring policy alignment, timely reviews, and compliant... ...role demands expert LTC UM knowledge, Medicaid managed care experience, and strong leadership in a matrix environment...Remote work
- ...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
$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$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$150k - $200k
...Southeastern US \n \n Director – Utility Substations About the Position... ..., Colorado) and full-time remote candidates. Essential Responsibilities... ...Resource Allocation and Management \n \n ~ Develops... ...equipment, etc.)\n ~ Dependent Care Match \n \n ‘Atwell’ness...Remote workFull timeWork at officeLocal area- ## 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
$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- ...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
- ...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
$130.33k - $195.48k
...providing excellence in patient care, embracing multi-... ...Description The Corporate Director of Care Management and Ambulatory Nursing provides... ...oversight of care management, utilization management, CDI programs,... ...models, including virtual care, remote monitoring, and cross-...Remote workContract workLocal area$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$86.67k - $130.01k
...intensive, individualized case management and support as needed... .... The Nurse Care Manager is a key member... ...and safely for as long as possible by developing... ...transitions, and service utilization. Active follow-up on... ...Spanish required Remote Type: On-site...Remote workFlexible hours- ...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
$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$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- ...CVS Health is seeking an experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on Medicare joint procedures... ...to coordinate treatment plans, ensuring appropriate care and utilization. The position requires 3+ years RN experience...Remote work
$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- ...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
- ...CVS Health is hiring for an Utilization Management Nurse Consultant (RN) for remote work. The role focuses on concurrent review and ensuring timely, cost-effective care through evidence-based decision-making. Candidates need active RN licensure, multi-state capability...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation... ...team, which oversees post-acute care services including SNF, home health,... ...medical necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
$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- ...Centurion is seeking a Full-time Director of Infection Control (Registered Nurse) to join our Springfield, Illinois regional office. This role is remote/traveling, with weekly travel varying from 1x to 5x as needed. Candidate must reside in Illinois and be within commutable...Remote workFull timeWork at office
- ...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
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