Utilization Manager Jobs in Providence
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Search Results - Utilization Manager Jobs in Providence
CommunityCare-Providence
to support timely utilization decisions
• Provide clinical consultation on complex medication requests and coverage determinations
• Support development and maintenance of medical drug utilization management programs
• Develop and maintain evidence-based...
Family Service of Rhode Island-Providence
or exceed productivity expectations.
Complete all professional and administrative documentation and forms in accordance with agency standards and within established guidelines and timeframes.
Prepare for and participate in Utilization Management process...
jobvertise.com -
UnitedHealth Group-Providence
Overview
In this leadership role, you steer a diverse training and quality team across multiple sites to elevate utilization management operations. You will design and deliver onboarding and ongoing education, align quality initiatives...
Accenture-Boston, 41 mi from Providence
Utilization Management Consulting Manager, your primary responsibilities may include: Lead the planning and successful delivery of client engagements, managing the work of Accenture and client working teams and participating directly in project delivery...
UnitedHealth Group-Providence
Overview
As Medical Director, you guide clinical coverage determinations within Enterprise Clinical Services, collaborating with leadership to ensure high-quality, cost-effective patient care. You lead utilization management activities and engage...
Fallon Community Health Plan-Worcester, 38 mi from Providence
effective, evidence-based care management and utilization management programs.This position is responsible for conducting medical necessity reviews, provider and member appeals, peer-to-peer consultations, and medical director on-call activities.
The Medical...
Alignment Healthcare-Providence
Overview
In this Regional Medical Director role, you lead non-acute utilization management across markets to optimize clinical outcomes, quality, and total cost of care. You collaborate with regional leaders and provider networks to advance prior...
Family Service of Rhode Island-Providence
sensitivity to clients and families cultural, ethnic, racial and socioeconomic issues and diversity
Serve as a positive role model to clients and colleagues
Maintain or exceed productivity expectations
Prepare for and participate in Utilization Management Case...
jobvertise.com -
UnitedHealth Group-Providence
Overview
In this role you support authorization decisions for psychiatric and chemical dependency care, working within Utilization Management to ensure medical necessity and efficient care transitions. You will handle data entry, coordination...
Boston Medical Center-Brockton (MA), 26 mi from Providence
faculty related meetings pertaining to safety, quality, utilization management, and other departmental committee meetings Oversee credentialing, privileging, performance metrics, and staff engagement processesParticipate and arrange psychiatric coverage...
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