Utilization management jobs

Medical Director – Utilization Management

Remote

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Today

Were looking for an experienced Medical Director (Utilization Management) to help lead clinical integrity and medical necessity decision-making across inpatient and post-acute care services for Medicare Advantage members. Reporting directly to the Chief Medical Officer, this physician leader will play a key role in ensuring appropriate, evidence-based, and compliant care decisions that support quality outcomes, cost efficiency, and regulatory excellence. What Youll DoConduct medical necessity r

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Full-time

160000

Epic Certified Tapestry Analyst

No location provided

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Today

Our nationwide remote client is seeking (4) Certified Epic Tapestry Analysts for a 3-6 month+ engagement and contract to hire starting in February. Requires Epic Tapestry certifications with CEE's. The 3 roles: Epic Tapestry Medical Management - Utilization Management (UM), Case Management (CM), Provider configuration.Epic Tapestry Claims (or) Membership AnalystEpic Tapestry Health Plan Architect Must be able to work as a W2. This position is not open to vendors To learn more about this and ot

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Full-time

Salesforce Developer with System Integration and Health cloud

Remote

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Today

We're seeking a Salesforce Developer with strong experience in system integrations and Health Cloud configuration. You'll design and build secure integrations to EHRs and healthcare platforms, configure Health Cloud capabilities (Care Programs, Patient/Provider management, Assessments), and develop scalable components using Apex/LWC/Flows. What You'll Do Design, build, and maintain integrations with Health Cloud and thirdparty systems. Ensure security & compliance (HIPAA, PHI/PII), OAuth 2.0/JWT

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Contract

Depends on Experience

Senior Systems Safety Engineer

Mesa, Arizona

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Today

Overview We are seeking a full-time Senior Aircraft Systems Safety Engineer in our Mesa,AZ location. In this role, you will be responsible for overseeing the aircraft system safety assessment process and generating and approving the required analyses in support of Garmin STC projects. Essential Functions Work with system safety analysts to establish the system safety approach and documentation necessary to show compliance for Garmin STCSupport the generation and UM approval of System Safety Ass

Full-time

SAP Application/ GRC security consultant

St. Louis, Missouri

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Today

SAP Application/ GRC security consultant Location: St. Louis MO or weekly M-F travel to St. Louis MO Need Active Secret clearance The senior SAP Application security specialist is responsible for performing all User Management (UM) functions such as user role creations, changes, assignments, and activities including User Access Review, UM audit requests, and Segregation of Duties (SOD) Risk Assessment. Responsibilities include: Leading and participating in User Access Management design, implemen

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Contract

Depends on Experience

Technical Lead EMC Engineer

Olathe, Kansas

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Today

Overview We are seeking a full-time Technical Lead EMC Engineer in our Olathe, KS or Cary, NC location. In this role, you will be responsible for being a key technical contributor and/or project manager for Electromagnetic Compatibility (EMC) Certification and/or testing related to complicated projects and will serve as a mentor and provides guidance to less experienced EMC engineers. Essential Functions Reviews new project proposals and provides guidance to resolve any issuesDemonstrates good

Full-time

Aetna Technology Medicaid Senior Product Manager

Remote or Downers Grove, Illinois

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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 CVS Health is embarking on a bold digi

Full-time

USD 118,450.00 - 260,590.00 per year

Epic Tapestry UM Analyst - 100% Remote

Remote or Eden Prairie, Minnesota

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Today

Genesis10 is currently seeking a Tapestry UM Analyst for a 3-month contract role with our client. This role will be 100% remote. Compensation: $80.00 - 90.00 per hour, W2, depending on skill and experience level. Summary: We are seeking an experienced Epic Tapestry Utilization Management (UM) Analyst to design, build, optimize, and support UM workflows focused on prior authorizations and referrals. This role partners closely with UM leadership, clinical reviewers, provider relations, care manag

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Full-time

USD 80.00 - 90.00 per hour

Engineer, Analog Design Engineering

Wilmington, Massachusetts

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Today

About Analog Devices Analog Devices, Inc. (NASDAQ: ADI ) is a global semiconductor leader that bridges the physical and digital worlds to enable breakthroughs at the Intelligent Edge. ADI combines analog, digital, and software technologies into solutions that help drive advancements in digitized factories, mobility, and digital healthcare, combat climate change, and reliably connect humans and the world. With revenue of more than $9 billion in FY24 and approximately 24,000 people globally, ADI

Full-time

USD 86,400.00 - 118,800.00 per year

Chief Medical Officer

Hartford, Connecticut

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5d ago

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide m

Full-time

USD 262,900.00 - 404,200.00 per year

Data Analyst II Healthcare Analytics

Remote or Florida

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Today

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v

Full-time

USD 56,200.00 - 101,000.00 per year

Data Analyst II Healthcare Analytics

Remote or Michigan

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Today

Full-time

USD 56,200.00 - 101,000.00 per year

Telecom Specialist

Rochester, New York

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Today

Telecom / Voice Systems Technician (ON-SITE) LOCATION: ROCHESTER, NY Overview We are seeking an experienced Telecom / Voice Systems Technician to support and maintain enterprise voice, data, and video services in a 24x7 environment. The ideal candidate will have hands-on experience with VOIP and NEC phone systems, Distributed Antenna Systems (DAS), and end-to-end voice troubleshooting. This role involves system programming, documentation, infrastructure updates, and working closely with interna

Full-time

USD 25.00 - 40.00 per hour

Experienced Structural Repair Engineer

Seal Beach, California

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Today

Experienced Structural Repair Engineer Company: The Boeing Company The Boeing Commercial Airplanes (BCA) is seeking an Experienced Structural Repair Engineer to join their team in Seal Beach, CA. As a Structural Repair Engineer, you will provide support in the development of the Structural Repair Manual (SRM). You'll be responsible for participating in the development of practical and economical retrofit and repair plans to meet customer needs, which will be incorporated into the SRM. Positi

Full-time

USD 111,350.00 - 150,650.00 per year

Sr Aerospace Engineer - Aircraft Certification

Remote or Plano, Texas

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Today

The ISR (Intelligence, Surveillance & Reconnaissance), Aviation, and Security (IAS) business area is a leader in ISR and aviation, it is a leading prime manned and unmanned aircraft systems integrator for innovative, high-performance ISR and aviation systems. Its end-to-end Command, Control, Computers, Communications and Intelligence, Surveillance & Reconnaissance (C4ISR) capabilities encompass design, integration, test, certification, ground/flight training and complete logistics support. IAS t

Full-time

Telecom Specialist

Rochester, New York

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Today

Telecom Specialist - On-Site | Rochester, NY | Contract-to-Hire Employment Type: Contract-to-Hire (6 months) Pay Range: $25-$40/hr (based on experience) Workplace: Telecom / Data Center Environment Schedule: Full-time, includes on-call rotation Why You'll Love This Role This is a unique opportunity to join a highly stable organization with a long-standing, well-structured telecom environment. You'll step into a position where your expertise truly matters - supporting voice, data, and telecom

Full-time

USD 25.00 - 40.00 per hour

Sr. Software Engineering Manager

Anchorage, Alaska

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Today

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have

Full-time

USD 108,000.00 - 155,000.00 per year

Sr. Performance Improvement Program Manager (RN)

Newark, Delaware

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Today

Sr. Performance Improvement Program Manager (RN) Monday-Friday - (Day Shift) Newark DE ChristianaCare is seeking a Senior Performance Improvement Program Manager (RN) to join our team. This healthcare quality professional will provide leadership and support for systemwide performance improvement initiatives that align with our organizational mission, priorities, and goals. Key responsibilities include: - Performance Improvement - Oversight of outcome measure reporting. - Management of quality,

Full-time

Compensation information provided in the description

AMS Verification Engineer

Wilmington, Massachusetts

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Today

Full-time

USD 108,800.00 - 149,600.00 per year

Telecommunications Specialist

Rochester, New York

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Today

Description Leads the technical support that ensures stable and continuous service for end users whose business functions rely on voice, data or video services in a 24x7 environment. Maintains expertise in and mentors others on current telephony and network technologies. Analyzes, triages, designs, installs, upgrades, monitors, tests and repairs telephone, data and video systems, as well as manages cable plant, switch rooms and CER's. Oversees contractors, vendors and other technicians. Programs

Full-time

USD 25.00 - 40.00 per hour

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Utilization management jobs