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Strategic Events Associate Manager
Salesforce, Inc.
CA
- $94,000 to $155,200 USD / year
Assist the team lead with administrative and operational tasks supporting global World Tour ownership, and drive project management across core program functions, coordinating multiple…
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Business Excellence Manager, LATAM
Abbott Products Operations AG, Allschwil
FL
Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
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Lab Supervisor, Incoming Lab - Sturgis, MI Plant
Abbott Laboratories
MI
Vacation – 120 hours of accrued vacation (1st yr is prorated) + vacation buy program + 3 personal days + 10 paid holidays
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Manager, Clinical Affairs Specimen Operations
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WI · CA
The Manager, CASO will focus on leading and managing cross functional support teams and key stakeholders to support the logistical stand up of all clinical studies and ensure that supply…
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Senior Brand Manager, Trade
Abbott Diabetes Care Sales Corporation
CA
Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
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Engineering Manager
Abbott Diagnostics Int ltd
United States
Engineering Manager, this position is on-site at our Vascular manufacturing facility in Barceloneta, Puerto Rico.
Added 1 min ago
FAA Test Technician - Level 4 (2nd shift)
Aerospace
Clearwater, FL
You will report directly to our Engineering Manager and you’ll work out of our Clearwater, FL location on an on-site work schedule.
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Civil Engineer Project Manager
RTM Engineering Consultants, LLC
Schaumburg, IL · Rogers, AR · Overland Park, KS · Irvine, CA · Davenport, IA · Corona, CA · Chicago, IL
…include medical, dental, and vision plans, employee assistance program, disability coverage, life insurance, 401(k) and profit sharing, flexible work schedule, paid time off and training…
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Sr. Manager Business Analysis - Medicare / Medicaid
CVS Health
Hartford, CT · Scottsdale, AZ
The Senior Manager, Strategic Programs Business Solutions Liaison is a senior individual contributor within Medicare business who leads the business-side delivery of complex,…
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ROW Assistant or Agent
Electric Power Systems Inc
Anchorage, AK
…in compliance with the Uniform Act; participate in regular project meetings; obtain complicated land use and regulatory permits required for capital projects; prepare property valuations in…
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Program Analyst
Missile Defense Agency
Redstone Arsenal, AL · Fort Belvoir, VA
- $93,216 to $158,322 USD / year
Support Senior Project Manager (PM) and Deputy Project Manager (DPM) by providing analysis and recommendations for accomplishing cost, schedule and technical performance objectives.
Added 2 mins ago
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Supervisory Program Analyst
National Nuclear Security Administration
Albuquerque, NM
- $107,592 to $165,288 USD / year
This position will serve as a Supervisory Program Analyst and will be responsible for a broad range of business management and organizational issues tied to Federal Training including…
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Supervisory Program Manager (Deputy Associate Administrator) - EXCEPTED SERVICE
Federal Transit Administration
Washington, DC
- $169,279 to $197,200 USD / year
As a Supervisory Program Manager (Deputy Associate Administrator), you will:
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Sr. Manager Facilities Office Services - Orlando Onsite
GuideWell
Orlando, FL · FL
…Establish, implement, manage and maintain a preventative maintenance program for building/facility components, systems and…
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Internal Controls Optimization Lead
Dow Jones & Company, Inc.
United States
…organization evolves. You will report to the Intnl Controls/Compliance Manager and be based in our New Jersey…
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HR Specialist (Vendor Manager) Fully Remote
Aston Carter
Atlanta, GA
- $28 USD / hour
…and Accommodations team is looking for an experienced Vendor Manager to join our team.Leave and Accommodations team is looking for a motivated Vendor Manager to join the team that owns the…
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Inside Sales Specialist
Aston Carter
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- $24.04 to $28.85 USD / hour
Develop and manage daily pricing strategies in support of customer contracts, project bids, and MRO agreements.
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HR Specialist (Vendor Manager) Fully Remote
Aston Carter
Dallas, TX
- $28 USD / hour
…and Accommodations team is looking for an experienced Vendor Manager to join our team.Leave and Accommodations team is looking for a motivated Vendor Manager to join the team that owns the…
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Remote Procurement Specialist
Aston Carter
Atlanta, GA
- $28 USD / hour
DescriptionLeave and Accommodations team is looking for a motivated Vendor Manager to join the team that owns the relationships with a growing list of vendors worldwide. The ideal candidate…
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Assistant Controller
Aston Carter
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- $90,000 to $125,000 USD / year
…reporting, internal controls, process improvement, and construction project accounting.The company is open to candidates coming from a Senior Accountant, Accounting Manager, Assistant…
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Program Manager
Aston Carter
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Communicate and track program changes as flowed down by Prime/Company.
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Architectural Project Manager
Mead + Hunt
Chicago, IL
As a result of our steadfast success, we have a full-time position available for an experienced Project Manager to join our Architecture North group. This exciting opportunity is available…
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Grants Manager
Family Health Center
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The Grants Manager is one of two managers who share responsibility for Family Health Center of Worcester's grants portfolio, leading grant development and writing as well as post-award…
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Eligibility Supervisor
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Incumbents in the Eligibility Supervisor classification generally receive direct supervision from a Program Manager or other designated manager. Eligibility Supervisors provide direct…
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Senior Manager Creative Services
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Training & Development: A comprehensive and structured training program, complemented by ongoing education and opportunities for career advancement.

Closed listing

Acacia Network

Utilization Manager

Bronx, NY, United States

$35.16 USD / hour

This opening has closed.

The original listing is kept below for reference.

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Job details

Pay: $35.16 USD / hour
Experience: Minimum of 2 years of case management and/or utilization review experience
Posting language: English
Posted: Mar 26, 2026

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Original job description

Archived listing. The details below describe a past opening.

Regular Full-Time

Bronx, NY, US

Requisition ID: 1874

Salary: $35.16 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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