Jobs in the United States

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Added 3 mins ago
Luxury Bridal Manager - Jared Jewelers - Southern Trails Shopping Center
Sterling Inc
Tulsa, OK
Training - Associate Training System, Management Training System, District Manager in Training, career development and more
Added 4 mins ago
Office Manager
VIPcare
Panama City, FL
The Office Manager is responsible for leading the day-to-day operations of an assigned medical practice while fostering a high-performing, patient-centered culture that delivers Five-Star…
Added 4 mins ago
Associate Manager PT 20-29 hours
Tumi
San Antonio, TX
As part of our Retail team, the Associate Manager is responsible for creating a client experience that accurately reflects the ethos of our brand while building and maintaining strong…
Added 5 mins ago
PB
IT Project Manager - Healthcare
Proven Business Systems LLC
Tinley Park, IL
- $80,000 to $90,000 USD / year
The Healthcare IT Project Manager is a highly customer-facing role dedicated exclusively to the RTS/healthcare project portfolio. The position plans, coordinates, and governs healthcare IT…
Added 5 mins ago
Subsidy Specialist
Father Bills & Mainspring
Brockton, MA
…position requires excellent organizational skills and adherence to program requirements, but flexibility and an understanding of the nuances of working with a complex population. Full-time…
Added 6 mins ago
HL
Retail Key Carrier
Homegoods LLC
Tucker, GA
- $15.25 to $15.75 USD / hour
Benefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral…
Added 7 mins ago
Yankee Candle-Retail Seasonal Sales Associate - Chesapeake, VA
United States
Drive guest loyalty through the Rewards Loyalty program and Key Performance Indicators (KPIs).
Added 9 mins ago
W
Operations Manager - Seattle, WA
WM
Seattle, WA
- $80,168.4 to $108,000 USD / year
Successful completion of the WM Operations Manager Trainee program
Added 10 mins ago
NM
Security Officer I - Woodstock, Full-time, Days
Northwestern Memorial Healthcare
Woodstock, IL
- $20 to $29 USD / hour
- Full-time
…the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation…
Added 11 mins ago
Business Development Industrial Account Manager - MSC - Remote
Stanley Black and Decker
IL
As a Business Development Industrial Account Manager, you’ll be part of our MSC Industrial Sales team working as a remote employee. This role is responsible for increasing the sales of…
Added 11 mins ago
Assistant Nurse Manager Emergency
AdventHealth
Hinsdale, IL
Neonatal Resuscitation Program - Advanced (NRP-A) [Preferred]
Added 11 mins ago
CG
FLOOR TECHNICIAN (FULL AND PART TIME)
Compass Group, North America
Hinsdale, IL
- $20 to $25 USD / hour
- Part-time
Full-time and part-time positions are offered the following benefits: Retirement Plan, Associate Shopping Program, Health and Wellness Programs, Discount Marketplace, Identify Theft…
Added 11 mins ago
B
Retail Front End Supervisor - Full-Time
Burlington
Wheaton, IL
- $18 to $20 USD / hour
- Full-time
Supervise all store functions and associates while in the role of Manager on Duty
Added 11 mins ago
CT
TT QA Technician
Continental Tire the Americas, LLC
Mount Vernon, IL
- $55,683 USD / year
Perform other duties as directed by the Chief Inspector or QA Manager.
Added 11 mins ago
E
Event Technical Lead, Audio Visual (Part Time Casual) - Chicago
Encore
Elmhurst, IL
- $17.21 to $22.37 USD / hour
- Part-time
…customer satisfaction. This position reports to an Operations Manager, Operations Director, or Director of Event…
Added 11 mins ago
FT
Personal Banker Associate II - Romeoville - Full-Time
Fifth Third Bank, N.A.
Romeoville, IL
- Full-time
…Banker II after completing a 4-8 week on-boarding and education program that includes rotations in Operations and Sales & Service. There will be a certification at the conclusion of the…
Added 11 mins ago
Store Manager
Bridgestone Americas
Crystal Lake, IL
Added 11 mins ago
ES
Assistant Store Manager - 3455
Extra Space Storage
Elgin, IL
- $17.5 to $18.54 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…
Added 11 mins ago
BB
Safety Associate
Block by Block
Champaign, IL
- $22 USD / hour
…agreements. Employee Recognition Awards, Employee Referral Bonus Program (select positions only), Bonus Program (Operations Manager, RVP, and executive positions…
Added 11 mins ago
BB
Cleaning Associate
Block by Block
Champaign, IL
- $22 USD / hour
…agreements. Employee Recognition Awards, Employee Referral Bonus Program (select positions only), Bonus Program (Operations Manager, RVP, and executive positions…
Added 11 mins ago
PP
IC&V Technician 1
PCI Pharma Services
Rockford, IL
- $24.58 to $27.65 USD / hour
Servo Drives: The ability to commission, program, and diagnose motion systems.
Added 11 mins ago
RFD_Clinical Associate Project Man
PCI Pharma Services
Rockford, IL
Provide continuous support to Project Manager and stay up to date on basic status of client projects owned by the team.
Added 11 mins ago
ES
Store Manager
Extra Space Storage
Peoria, IL
- $18 to $20 USD / hour
If you have experience in any of the following types of jobs, we encourage you to apply: Assistant Store Manager, Key Holder or Key Carrier, Retail or Shift Supervisor, Sales Lead, Customer…
Added 11 mins ago
ES
Assistant Store Manager
Extra Space Storage
Peoria, IL
- $17 to $18 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…
Added 11 mins ago
Care Manager, Telephonic Nurse
CenterWell
Springfield, IL
As a Care Manager, Telephonic Nurse , you will report directly to the Manager, Care Management. You will help to ensure optimal continuity of care for patients transitioning into and out of…

Closed listing

Acacia Network

Utilization Manager

Brooklyn, NY, United States

$32.96 USD / hour

This opening has closed.

The original listing is kept below for reference.

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About employer

Job details

Pay: $32.96 USD / hour
Experience: Minimum of 2 years of case management and/or utilization review experience
Posting language: English
Posted: Jan 14, 2026

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Original job description

Archived listing. The details below describe a past opening.

Regular Full-Time

Brooklyn, NY, US

Requisition ID: 1789

Salary: $32.96 Hourly

MISSION STATEMENT

Are you ready to give back to the community while pursuing your passion? For over 50 years, Acacia Network and its affiliates have been committed to improving the quality-of-life and wellbeing of underserved communities in New York City and beyond. We are one of the leading human services organizations in New York City and the largest Hispanic-led nonprofit in the State, serving over 150,000 individuals every year. Our programs serve individuals at every age and developmental level, from the very young through our daycare programs to mature adults through our older adults centers. Our extensive array of community-based services are fully integrated, bilingual and culturally competent.

POSITION OVERVIEW

The Utilization Manager is responsible for the day-to-day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation, and certification/recertification from third party payers at pre-admission through discharge, ongoing medical necessity reviews and interdisciplinary team support with respect to MCO requisites. In addition, this position is responsible for having a thorough understanding of patient treatment plans through participative discussions with the care plan (interdisciplinary) team, identifying and referring requests for services to the Medical Director when guidelines are not met and reviewing residential services requiring MCO approval.

KEY ESSENTIAL FUNCTIONS

Obtaining the required pre-authorization/certification of specified services from the MCO and communicating end of benefit status and/or reimbursement changes to Finance and others as deemed necessary.
Conducting ongoing medical necessity reviews, which may be pre-service, concurrent and/or retrospective in nature, by evaluating clinical data and submitting appropriate documentation to update the patient/resident’s status to the MCO as scheduled.
Acting as a liaison between the residential program and the MCO to better facilitate the reimbursement process.
Referring MCO denials and non-covered medical services to the directors for appeal determination and next steps
Conduct medical record reviews of all managed care patients within the first 24 to 72 hours (if admitted on a Friday after 5:00pm) then weekly as required to promote desired clinical and financial outcomes by, but not limited to:
Meeting with all managed care residents/patients to better assist in the selection of appropriate provider resources and identification of quality and cost-effective services throughout the continuum of care.
Acting as a resource to the interdisciplinary team regarding MCO requirements for admission, continued stay and discharge planning.
Providing early identification of covered care and ensuring that claims are approved when the requirements are met.
Collaborate with clinicians to identify discharge needs and coordinates with Social Services in the creation and implementation of a discharge/transfer plan.
Coordinates post-discharge follow-up care with selected patients and community providers.
Maintains strong leadership skills to perform the multiple functions and a wide variety of tasks requiring independent judgment, ingenuity, and initiative.
Interacts with executives, directors, key members of the residential team, physicians, and their staff, third party payers, state and federal agencies, auditors, and vendors.
Maintains a high degree of computer proficiency with MS Word and MS Excel which is critical for the analysis conducted using this technology.
Maintains all information in a manner such as to assure strict confidentiality and compliance with HIPPAA.
Maintains full knowledge and understanding of state and federal regulations as they pertain to resident assessment requirements.
Performs all other tasks including miscellaneous special projects as directed.

REQUIREMENTS

Minimum of 2 years of case management and/or utilization review experience
Associate degree required; bachelor's Degree preferred.
Strong problem-solving and advanced analytical skills necessary to read, understand, interpret, and analyze statistical data.
Excellent oral, written, organizational and interpersonal communication skills.
Ability to communicate effectively with senior leadership as well as other clinical/nonclinical directors, managers, staff, consultants and MCOs.
Demonstrated ability to effectively collaborate with peers and senior leadership on project assignments and group presentations.

WHY JOIN US?

Acacia Network provides a comprehensive and competitive benefits package to our employees. In addition to a competitive salary, our benefits include medical, dental, and vision coverage. We also offer generous paid time off, including vacation days and paid holidays, to support a healthy work-life balance. We prioritize the well-being of our employees both professionally and personally.

As an Equal Opportunity Employer, we encourage individuals from all backgrounds to apply.

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