Utilization management jobs

Board Certified Behavior Analyst (ABA/ Utilization Management)

Remote

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Yesterday

Active BCBA (Board Certified Behavior Analyst) certification and state licensure (MD, DC, or Virginia) - Required 3+ years of ABA (Applied Behavior Analysis) clinical experience - Required Experience creating and supervising ABA (Applied Behavior Analysis) treatment plans Direct patient care background (dealing with children with Behavior / Autism issues) Utilization Management or insurance review experience strongly preferred Comfortable reviewing medical necessity and authorization requests Fa

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Contract

Depends on Experience

Vice President of Software Engineering for Utilization Management

Eden Prairie, Minnesota

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Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. As the Vice P

Full-time

USD 200,400.00 - 343,500.00 per year

Facets/ Pre-Auth Consultant

Remote

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7d ago

As a Facets with Pre-Auth you will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Mandatory skills: facets,UM,Pre-Auth Healthcare Responsibilities: 7 - 10 years in UM/Pre-Auth configuration within FACETS. Familiarity with UM workflows, clinical guidelines, and state mandates. Experience working with clinical/utilization management stakeholders. Deep understanding of US Healthcare payer operations.

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Contract

Depends on Experience

Board Certified Behavior Analyst (ABA)

Remote

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4d ago

Easy Apply

Contract

Depends on Experience

System Configuration Analyst

Remote

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Today

Configure Systems. Improve Accuracy. Strengthen Outcomes.Do you thrive at the intersection of claims expertise, system configuration, and crossfunctional collaboration? Are you energized by solving complex Utilization Management (UM) and claims scenarios while ensuring systems work exactly as designed? LIBERTY Dental Plan is seeking a System Configuration Analyst to help ensure our claims and UM systems are accurate, efficient, and aligned with benefit design and regulatory expectations. In this

Full-time

$65,000 - $75,000

Senior Structural Analysis Engineer ? Wing & Empennage

North Charleston, South Carolina

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Today

Job Description At Boeing, we innovate and collaborate to make the world a better place. We?re committed to fostering an environment for every teammate that?s welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us. 787 Airframe in Boeing Commercial Airplanes is hiring for a Senior (Level 4) Structural Analysis Engineer for our Wing & Empennage Life Cycle Product Team to work at our North Charleston, SC location. At Boeing, our engineers shar

Full-time

Electrical Wiring Technician

Salt Lake City, Utah

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Today

American Equipment Holdings, is one of the leading overhead crane solutions providers in the United States. Over the years, our ability to grow and set ourselves apart from the competition is the result of a tried and true philosophy - take care of our customers and take care of our people. We also believe that our people matter, which is why we are committed to providing our team members with competitive wages, attractive benefit offerings, and abundant training offerings. As one of the fastes

Full-time

USD 27.00 - 30.00 per hour

IT Delivery Manager (Remote restricted in OR, WA, ID, UT or ND only)

Remote or Hybrid in Portland, Oregon

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13d ago

IT Delivery Manager (Remote restricted to OR, WA, ID, UT or ND only) Our client, a leading health care company dedicated to revolutionizing the industry, is seeking an experienced Release Manager / Delivery Lead to provide end-to-end coordination and delivery leadership across multiple clinical and technology initiatives. This role will work across Product Owners, business teams, technology (DTS), configuration, UAT/quality, project resources, vendors, and operational stakeholders to ensure wor

Contract

Senior Structural Analysis Engineer ? Interiors Stress

North Charleston, South Carolina

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Today

Job Description At Boeing, we innovate and collaborate to make the world a better place. We?re committed to fostering an environment for every teammate that?s welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us. 787 Airframe in Boeing Commercial Airplanes is hiring for a Senior (Level 4) Structural Analysis Engineer for our Interiors Stress team to work at our North Charleston, SC location. At Boeing, our engineers share a passion to red

Full-time

Compensation information provided in the description

Senior Structures Design Engineer ? Wing & Empennage

North Charleston, South Carolina

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Today

Job Description At Boeing, we innovate and collaborate to make the world a better place. We?re committed to fostering an environment for every teammate that?s welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us. 787 Airframe in Boeing Commercial Airplanes is hiring for a Senior (Level 4) Structures Design Engineer for our Wing & Empennage Life Cycle Product Team to work at our North Charleston, SC location. At Boeing, our engineers share

Full-time

Compensation information provided in the description

Unity Construct System Administrator

Columbia, Missouri

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Today

Hiring Department Operations Administration Job Description The Unity Construct System Administrator will serve as the primary contact for MU Campus Unity Connect users. This role is responsible for system configuration, modification of data fields and templates, providing support and training to both internal and external users, and addressing user needs in a timely and professional manner. Additionally, the Administrator will collaborate with system-level Unity Construct teams, campus Peopl

Full-time

USD 74,000.00 - 85,000.00 per year

Healthcare QA Test Lead - Medical Management - 100% Remote

Remote or Eagan, Minnesota

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Today

Genesis10 is currently seeking a Healthcare QA Test Lead position with a Major Healthcare Company located in Eagan, MN. This is a 12+ month contract opportunity. This role can be 100% remote. Compensation: $70.00 - $80.00 per hour, W2, based on qualifications Position Overview: We are seeking an experienced QA / Testing Lead to support a large-scale healthcare technology implementation. This individual will be responsible for leading testing strategy, planning, coordination, and execution acros

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Full-time

Compensation information provided in the description

Senior Structural Analysis Engineer - Wing & Empennage

South Carolina

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Today

Job Description At Boeing, we innovate and collaborate to make the world a better place. We're committed to fostering an environment for every teammate that's welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us. 787 Airframe in Boeing Commercial Airplanes is hiring for a Senior (Level 4) Structural Analysis Engineer for our Wing & Empennage Life Cycle Product Team to work at our North Charleston, SC location. At Boeing, our engineers shar

Full-time

USD 126,650.00 - 171,350.00 per year

Senior Structural Analysis Engineer - Wing & Empennage

South Carolina

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Today

Full-time

USD 126,650.00 - 171,350.00 per year

Results Management Industrial Engineer

Remote or Connecticut

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Schedule: REMOTE Monday-Friday 8A-5P in time zone of res

Full-time

USD 46,988.00 - 112,200.00 per year

Engineering Flight Test Pilot Principal

Duluth, Minnesota

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Today

Overview The Flight Test Pilot, Principalis a senior technical role responsible for the strategic planning, execution,and analysis of flight test programs for complex aerospace vehicles andsystems. This position involves high-level coordination, ensuring regulatorycompliance, leading large-scale testing efforts, and contributing to thecontinuous improvement of testing methodologies. As a key technical authority,the Flight Test Pilot Principle plays a pivotal role in ensuring the success ofcriti

Full-time

USD 170,145.26 - 255,217.88 per year

Senior Health Data Analyst I

Fairfield, California

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Today

Overview The Senior Healthcare Data Analyst I contributes to the overall success of the organization by developing analytic solutions that support activities related to health services utilization management, care coordination, quality improvement and population health. Through analyzing patient claims, member enrollment, and other data, the Senior Healthcare Data Analyst participates in identifying progress, performance and opportunities for improvement on programs, quality of care, patient ex

Full-time

USD 106,667.05 - 138,667.16 per year

Senior Airworthiness & Regulatory Engineer (Regulatory Compliance)

North Charleston, South Carolina

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Today

Job Description At Boeing, we innovate and collaborate to make the world a better place. We?re committed to fostering an environment for every teammate that?s welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us. The Boeing Company is seeking a Senior Airworthiness & Regulatory Engineer (Level 4 or Level 5) to join the Regulatory Administration and Airworthiness organization in North Charleston, South Carolina. This team has opportunities

Full-time

Compensation information provided in the description

System Support Analyst - Onsite

Columbia, Missouri

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Today

Hiring Department Division of Information Technology Job Description This computer technician position is focused on supporting the faculty, staff and students in the College of Veterinary Medicine and the Veterinary Health Centers. No two days are alike, and you will consistently be learning new things. Standard job duties include but are not limited to: Answer inquiries concerning technology including questions regarding usernames, passwords, MFA, networking, email, general purpose software

Full-time

USD 18.00 - 25.00 per hour

Senior Manager - Aetna Interoperability Data Governance

West Hartford, Connecticut

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary Serves as a senior governance operator

Full-time

USD 82,940.00 - 182,549.00 per year