620 utilization manager jobs found

Job Description Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Job Summary The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate class and level of care (LOC). This position works collaboratively with an interdisciplinary team (including physicians, other care providers, payers, etc.) to ensure the patient’s needs are met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the health system’s Utilization Review Plan. Responsibilities And Scope Uses approved criteria and conducts admission review/class change review as trigger by patient admission to the hospital to ensure appropriateness of the setting...

Job Description Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed...

Job Description Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Works in collaboration with the patient/family, and interdisciplinary team (including physicians, other care providers, and payors), and assesses the patient care progression from acute care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed...

Job Description Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate class and level of care (LOC). This position works collaboratively with an interdisciplinary team (including physicians, other care providers, payers, etc.) to ensure the patient’s needs are met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the health system’s Utilization Review Plan. Responsibilities: Uses approved criteria and conducts admission review/class change review as trigger by patient admission to the hospital to ensure appropriateness of the setting and timely implementation of the plan of care. Identifies...

Job Description Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate class and level of care (LOC). This position works collaboratively with an interdisciplinary team (including physicians, other care providers, payers, etc.) to ensure the patient’s needs are met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the health system’s Utilization Review Plan. Responsibilities: Uses approved criteria and conducts admission review/class change review as trigger by patient admission to the hospital to ensure appropriateness of the setting and timely implementation of the plan of care. Identifies...

Job Description Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: The Care Manager - RN provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of care management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. Responsibilities: Reviews new admissions and prioritize patients...

Job Description Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: The Care Manager - RN provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of care management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. Responsibilities: Reviews new admissions and prioritize patients...

Join our dynamic Care Management Leadership Team as an on-site manager at our UNC Chapel Hill campus, where you'll lead a skilled group of Care Managers, Social Workers, and Care Management Assistants.    Candidate must be a  Registered Nurse (RN)  or  Licensed Clinical Social Worker (LCSW/LCSWA) Preference given to candidates with acute hospital experience  Monday-Friday schedule during traditional business hours On-call rotation (approximately every five weeks)       Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Responsible for day-to-day operations for designated Clinical Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social Workers, Clinical Authorization Specialists, and Operational staff. Accountable for...

372550 Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center , Spring Valley Hospital Medical Center , Summerlin Hospital Medical Center Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital. Benefit Highlights: Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Career opportunities within VHS and UHS Subsidies Challenging and rewarding work environment Comprehensive education and training center Job Description: Under the supervision of the Regional Manager CDI manages day-to-day workflow, specifically the operations of the Clinical...

locationsMountain Lakes Medical Center time typeFull time posted onPosted 5 Days Ago job requisition idJR-76866 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) Job Summary: The LPN works under the direction of a Registered Nurse or Manager and functions within the LPN Scope of Practice. The LPN is responsible for providing direct patient care to patients with medical/surgical needs. This includes age appropriate interventions that meet physical, emotional,...

locationsKennestone Hospital time typeFull time posted onPosted 5 Days Ago job requisition idJR-75698 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) Job Summary: The RN Clinical Charge Nurse is responsible for directing and overseeing the daily activities of the unit on an assigned shift to assure successful safe delivery of care. The Charge Nurse is a caregiver and often takes modified patient care assignment. They practice in a clinical environment that is...

locationsNorth Fulton Physicians Building time typeFull time posted onPosted Yesterday job requisition idJR-75085 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Shift/Schedule: 8am-4:30pm Monday-Thursday 8am-2:30pm Friday Job Summary: The RN Oncology Infusion Therapy Clinician functions under the direction of the Manager Infusion Therapy or other designated leader. The RN Oncology Infusion Therapy Clinician demonstrates knowledge, competency, and clinical expertise...

locationsNorth Fulton Hospital time typePart time posted onPosted 2 Days Ago job requisition idJR-73995 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The LPN works under the direction of the direction of a Registered Nurse or Nurse Manager and functions within the LPN Scope of Practice. Provides care for the patient. This includes age appropriate interventions that meet physical, emotional, developmental, psychosocial and educational needs. The LPN is...

locations1800 Parkway Place time typePart time posted onPosted 5 Days Ago job requisition idJR-65495 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The LPN works under the direction of a Registered Nurse or Manager and functions within the LPN Scope of Practice. The LPN is responsible for providing direct patient care to patients with medical/surgical needs. This includes age appropriate interventions that meet physical, emotional, developmental,...

locationsCobb Hospital time typeFull time posted onPosted Yesterday job requisition idJR-74214 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) $20,000 Sign On Bonus for Nights for Qualified Candidates!!! How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of...

locationsKennestone Hospital time typeFull time posted onPosted 4 Days Ago job requisition idJR-79701 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Ready to take your nursing career beyond the bedside? Bring your clinical expertise to an onsite Registered Nurse (RN) Utilization Management role at Wellstar Kennestone in Marietta, Georgia, and connect virtually with hiring leaders. Virtual Hiring Event Date and Time Thursday, October 29, 2026 | 9:30 a.m.–3:00 p.m....

locationsColumbia County Medical Office time typeFull time posted onPosted Yesterday job requisition idJR-79836 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Come Join Us in Our New Medical Office Opening November, 2026!! Job Summary: The LPN works under the direction of a Registered Nurse or Manager and functions within the LPN Scope of Practice. The LPN is responsible for providing direct patient care to patients with medical/surgical needs. This includes age...

locationsWellstar Northwest Georgia Oncology Centers time typeFull time posted onPosted 3 Days Ago job requisition idJR-78773 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The LPN works under the direction of the direction of a Registered Nurse or Nurse Manager and functions within the LPN Scope of Practice. Provides care for the patient. This includes age appropriate interventions that meet physical, emotional, developmental, psychosocial and educational...

locationsWellstar MCG Health time typeFull time posted onPosted 2 Days Ago job requisition idJR-79555 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The Wound, Ostomy, and Continence Clinical Nurse (WOCN) functions under the direction of the Nurse Manager and provides acute and rehabilitative care for people with select disorders of the GI, GU and Integumentary systems. The WOCN serves as a resource to nursing and medical staff and is responsible for...

locationsCobb Hospital time typeFull time posted onPosted Yesterday job requisition idJR-77274 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: across the continuum, and engaging with patient and family to assure care needs are met the most complex cases during the patient's acute admission. The RN Sr requires strong clinical expertise to partner with physicians and care teams to drive optimal and efficient treatment plans to streamline progression of care...

locationsSpalding Medical Center time typeFull time posted onPosted 2 Days Ago job requisition idJR-78017 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The RN Clinical Charge Nurse is responsible for directing and overseeing the daily activities of the unit on an assigned shift to assure successful safe delivery of care. The Charge Nurse is a caregiver and often takes modified patient care assignment. They practice in a clinical environment that is...

locationsWellstar MCG Health time typeFull time posted onPosted Today job requisition idJR-78168 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) About the Facility      Learn more about Wellstar MCG Health Medical Center , including our teams, culture, and campus environment:      Wellstar MCG Health Medical Center | Wellstar Health System      Hours: Full Time Nights 36 Hours per week (3/12s)    Sign on Bonus Available Job Summary: The RN...

locationsKennestone Hospital time typePart time posted onPosted Yesterday job requisition idJR-78140 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Night (United States of America) Job Summary: The RN Clinical Charge Nurse is responsible for directing and overseeing the daily activities of the unit on an assigned shift to assure successful safe delivery of care. The Charge Nurse is a caregiver and often takes modified patient care assignment. They practice in a clinical environment that is...

locationsCobb Hospital time typeFull time posted onPosted 6 Days Ago job requisition idJR-77545 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Hours: 7AM-5:30PM-Monday-Friday-4/10's Call Required within 30 minute Holiday Call Required-Weekends Included when on Call Bonus Eligible for Qualified RN Candidates Job Summary: Functions under the direction of the Site Manager. He/she is responsible for performing a wide variety of clinical procedures requiring...