Talent.com
RN Licensed Utilization Management Director
RN Licensed Utilization Management DirectorVirtualVocations • Bronx, New York, United States
RN Licensed Utilization Management Director

RN Licensed Utilization Management Director

VirtualVocations • Bronx, New York, United States
30+ days ago
Job type
  • Full-time
Job description

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

Create a job alert for this search

Rn Utilization Management • Bronx, New York, United States

Related jobs
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Bronx, New York, United States
Full-time
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...Show more
Last updated: 30+ days ago • Promoted
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Jamaica, New York, United States
Full-time
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...Show more
Last updated: 2 days ago • Promoted
California Licensed Utilization Review Clinician

California Licensed Utilization Review Clinician

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates member's treatment for mental health and substance abuse to ensure appropriateness of ca...Show more
Last updated: 30+ days ago • Promoted
State Licensed Utilization Review Nurse

State Licensed Utilization Review Nurse

VirtualVocations • New York, New York, United States
Full-time
A company is looking for a Utilization Review Nurse.Key Responsibilities Review and evaluate electronic medical records for emergency department admissions and screen for medical necessity Apply...Show more
Last updated: 30+ days ago • Promoted
California Licensed Utilization Management Nurse

California Licensed Utilization Management Nurse

VirtualVocations • Newark, New Jersey, United States
Full-time
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...Show more
Last updated: 23 days ago • Promoted
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Yonkers, New York, United States
Full-time
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...Show more
Last updated: 3 days ago • Promoted
Tennessee RN Utilization Review

Tennessee RN Utilization Review

VirtualVocations • Newark, New Jersey, United States
Full-time
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...Show more
Last updated: 3 days ago • Promoted
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Yonkers, New York, United States
Full-time
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...Show more
Last updated: 30+ days ago • Promoted
Ohio Licensed Care Management Manager

Ohio Licensed Care Management Manager

VirtualVocations • Jamaica, New York, United States
Full-time
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...Show more
Last updated: 3 days ago • Promoted
Texas Licensed Concurrent Review RN

Texas Licensed Concurrent Review RN

VirtualVocations • Bronx, New York, United States
Full-time
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...Show more
Last updated: 3 days ago • Promoted
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Paterson, New Jersey, United States
Full-time
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...Show more
Last updated: 1 day ago • Promoted
Travel Nurse RN - Clinic

Travel Nurse RN - Clinic

Prime Staffing • Cortlandt Manor, NY, US
Permanent
Prime Staffing is seeking a travel nurse RN Clinic for a travel nursing job in Cortlandt Manor, New York.Job Description & Requirements. At Prime Staffing, we understand the importance of findin...Show more
Last updated: 9 days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Elizabeth, New Jersey, United States
Full-time
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...Show more
Last updated: 2 days ago • Promoted
Ohio Licensed Utilization Management Nurse

Ohio Licensed Utilization Management Nurse

VirtualVocations • Newark, New Jersey, United States
Full-time
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...Show more
Last updated: 30+ days ago • Promoted
Director, Outpatient OB-GYN Clinic

Director, Outpatient OB-GYN Clinic

Stamford Health • Stamford, CT, United States
Full-time
Director, Outpatient OB-GYN Clinic.Stamford Hospital, Department of Obstetrics & Gynecology.The Department of Obstetrics & Gynecology at Stamford Hospital is seeking a dedicated physician to serve ...Show more
Last updated: 3 hours ago • Promoted • New!
Oklahoma Licensed Utilization Review Clinician

Oklahoma Licensed Utilization Review Clinician

VirtualVocations • Elizabeth, New Jersey, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluate member treatment for mental health and substance abuse to ensure medical appropriateness ...Show more
Last updated: 30+ days ago • Promoted
Travel Nurse - RN - LD - Labor and Delivery - $2926.75 / Week - Hiring Now

Travel Nurse - RN - LD - Labor and Delivery - $2926.75 / Week - Hiring Now

Cynet Health • Cortlandt Manor, NY, US
Full-time
Cynet Health is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Cortlandt Manor, NY. Shift : 3x12 hr nights Start Date : 12 / 29 / 2025 Duration : 6 weeks P...Show more
Last updated: 8 hours ago • Promoted • New!
Tennessee Licensed Utilization Review Clinician

Tennessee Licensed Utilization Review Clinician

VirtualVocations • Yonkers, New York, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluate member's treatment for mental health and substance abuse to ensure medical appropriatenes...Show more
Last updated: 4 days ago • Promoted