Talent.com
RN Licensed Utilization Management Director
RN Licensed Utilization Management DirectorVirtualVocations • Chula Vista, California, United States
RN Licensed Utilization Management Director

RN Licensed Utilization Management Director

VirtualVocations • Chula Vista, California, United States
Hace más de 30 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

A company is looking for a Director, Utilization Management Support Operations.

Key Responsibilities

Directs the utilization management team to ensure compliance with policies and procedures for optimal member outcomes

Reviews and analyzes utilization trends to enhance the effectiveness of the utilization program

Provides strategic leadership for the Peer-to-Peer Call Center, ensuring timely communication and operational efficiency

Required Qualifications

Bachelor's degree required

7+ years of related experience, including prior management experience

4+ years of management experience preferred

Expert knowledge of industry regulations and standards preferred

Healthcare background in a call center environment is highly preferred

Crear una alerta de empleo para esta búsqueda

Rn Utilization Management • Chula Vista, California, United States

Ofertas relacionadas
Florida Licensed Utilization Management RN

Florida Licensed Utilization Management RN

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Management Registered Nurse - Remote.Key Responsibilities Analyze patient records to determine the legitimacy of hospital admissions and appropriate levels ...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Ohio Licensed Utilization Management Nurse

Ohio Licensed Utilization Management Nurse

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Management Nurse Consultant.Key Responsibilities Assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members Gather clinical...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services to ensure medica...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Management RN Reviewer.Key Responsibilities Conduct admission, concurrent, and retrospective reviews of patient charts and clinical systems Collaborate wit...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Mostrar más
Última actualización: hace 4 días • Oferta promocionada
Clinical Social Worker

Clinical Social Worker

California Department of Corrections and Rehabilitation • DULZURA, California, US
A tiempo completo
Position : Clinical Social Worker Increased Salaries are Just the Beginning… The past few years have seen dramatic shifts in the health care landscape. California Correctional Health Care Services (C...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
California Licensed Utilization Management Nurse

California Licensed Utilization Management Nurse

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Management Nurse - LVN (Work from Home).Key Responsibilities Perform medical necessity reviews for assigned members Collaborate with the Medical Director o...Mostrar más
Última actualización: hace 25 días • Oferta promocionada
(RN) Manager, Utilization Management

(RN) Manager, Utilization Management

UC San Diego Health • San Diego, CA, United States
A tiempo completo
Eligible Special Selection clients should contact their Disability Counselor for assistance.The qualifications of this position have been slightly modified as of 10 / 3 / 2025.The Manager of Utilizatio...Mostrar más
Última actualización: hace 23 días • Oferta promocionada
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Review Nurse responsible for managing pre-claim prior authorization denials for pharmacy and medical benefits. Key Responsibilities Review and assess prior a...Mostrar más
Última actualización: hace 3 días • Oferta promocionada
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Review Nurse - Remote.Key Responsibilities Review prior authorization requests for medical necessity and manage medical claims disputes Coordinate transiti...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Ohio Licensed Care Management Manager

Ohio Licensed Care Management Manager

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Manager, Community-Based Care Management.Key Responsibilities Oversee a team of clinical and nonclinical staff to meet service level and production expectations Facili...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
(RN) Manager, Utilization Management

(RN) Manager, Utilization Management

UC San Diego • San Diego, CA, United States
A tiempo completo
Greenwich Drive, San Diego, CA 92122, United States .RN) Manager, Utilization Management.Extended Deadline : Fri 10 / 31 / 2025. UC San Diego values and welcomes people from all backgrounds.If yo...Mostrar más
Última actualización: hace 23 días • Oferta promocionada
(RN) Manager, Utilization Management - 136750

(RN) Manager, Utilization Management - 136750

UC San Diego Health • San Diego, CA, United States
A tiempo completo
Eligible Special Selection clients should contact their Disability Counselor for assistance.The qualifications of this position have been slightly modified as of 10 / 3 / 2025.The Manager of Utilizatio...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for a Utilization Nurse Reviewer (Remote).Key Responsibilities Conduct timely clinical chart reviews and communicate effectively with third-party payers Review admission ser...Mostrar más
Última actualización: hace 4 días • Oferta promocionada
(RN) Manager, Utilization Management - 136750

(RN) Manager, Utilization Management - 136750

UC San Diego • San Diego, CA, United States
A tiempo completo
Greenwich Drive, San Diego, CA 92122, United States .RN) Manager, Utilization Management.Extended Deadline : Fri 10 / 31 / 2025. UC San Diego values and welcomes people from all backgrounds.If you are in...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Psychiatric Technician - Statewide in CA

Psychiatric Technician - Statewide in CA

California Department of Corrections and Rehabilitation • Dulzura, California, US
A tiempo completo
Psychiatric Technician - Statewide in CA Position : Psychiatric Technician Location : Statewide - Multiple Locations Throughout California Annual Salary Range : $71,460 - $105,084 California Correctio...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Tennessee RN Utilization Review

Tennessee RN Utilization Review

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for an RN Utilization Review.Key Responsibilities Perform clinical assessments and evaluate injured employees' treatment utilization and compliance Collaborate with healthca...Mostrar más
Última actualización: hace 5 días • Oferta promocionada
Texas Licensed Concurrent Review RN

Texas Licensed Concurrent Review RN

VirtualVocations • Chula Vista, California, United States
A tiempo completo
A company is looking for an RN Concurrent Review.Key Responsibilities Monitor and document medical treatment telephonically, ensuring compliance with established guidelines Track patient progres...Mostrar más
Última actualización: hace 5 días • Oferta promocionada