Jobs in the United States

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WC
Apartment Maintenance Technician II
Windsor Communities
Boston, MA
- $24.52 to $30.66 USD / hour
Inventory Management: Manage and track inventory of maintenance supplies and equipment. Request replacements as needed from Service Manager.
Added just now
WC
Apartment Maintenance Technician II
Windsor Communities
Atlanta, GA
- $20.52 to $25.65 USD / hour
Inventory Management: Manage and track inventory of maintenance supplies and equipment. Request replacements as needed from Service Manager.
Added just now
Maintenance Manager-TMV
FPL FOOD, LLC
THOMASVILLE, GA
FPL Food, LLC is seeking an experienced Maintenance Manager to lead maintenance operations in our food manufacturing facility. You’ll improve equipment reliability, develop your team, and…
Added just now
Senior Project Manager, Power Systems Distribution
North Carolina Advanced Energy Corporation
Raleigh, NC
The role combines strong project management with technical expertise and serves as a bridge among clients, technical and cross-functional teams, and project delivery. The Senior Project…
Added 1 min ago
Route Service Representative, Rockmart, GA
NOVO Health Services, LLC
Rockmart, GA
Get to know us: NOVO Health Services offers linen management solutions to the healthcare industry. NOVO Health keenly focuses on safety and infection control and provides its partner…
Added 1 min ago
Route Service Representative, Louisville, KY
NOVO Health Services, LLC
Louisville, KY
Get to know us: NOVO Health Services offers linen management solutions to the healthcare industry. NOVO Health keenly focuses on safety and infection control and provides its partner…
Added 1 min ago
Financial Service Representative
Attain Finance
Harrisburg, IL
…promoting from within. Today, I am proud to serve as a District Manager, a position I moved into in 2021 – Also, a testament to the growth opportunities the company provides. The company…
Added 1 min ago
Accounting Manager
Long Home Products
Savage, MD
We're looking for an experienced and detail-oriented Accounting Manager to join our team!
Added 1 min ago
Assembly Supervisor
ASSA ABLOY
Phoenix, AZ
…operations. Reporting directly to the Technical Operations Manager, you will be the primary point of contact for the team, driving quality, efficiency, and on-time delivery of our…
Added 1 min ago
PM
Engineering Configuration Analyst (Epicor)
Premier Marine
Big Lake, MN
- $80,000 to $100,000 USD / year
Own front-end configuration management: maintain the models, option structure, and configurator rules, and partner with sales, product management, and engineering to add new options and…
Added 1 min ago
CH
Pharmacy Manager - Store 09293
CVS Health
Apache Junction, AZ
- $65 to $85 USD / hour
The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to:
Added 1 min ago
CH
Pharmacy Manager - Store 16952
CVS Health
Champlin, MN
- $65 to $85 USD / hour
The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to:
Added 1 min ago
Spend Manager
Vizient, Inc.
Chicago, IL
…solutions. You will collaborate with Spend Executives, Category Management, and cross-functional teams to align supply chain strategies with client goals and deliver measurable value…
Added 1 min ago
Tax Consultnat II
ADP
Maitland, FL
In this position you will be responsible for the successful delivery of Tax Account Management Services. Ensures employment tax filing and payment obligations are met in compliance with PEO…
Added 1 min ago
Retirement Services District Manager
ADP
Tempe, AZ
Proven Winner. You have an impressive track record (2+ years) of outside business-to-business sales experience including prospecting and territory management.
Added 1 min ago
Retirement Services District Manager
ADP
Fort Myers, FL
Proven Winner. You have an impressive track record (2+ years) of outside business-to-business sales experience including prospecting and territory management.
Added 1 min ago
Branch Receptionist
Cowin Equipment Company, Inc - Atlanta
Mableton, GA
Must have a pleasant personality and ability to work well with others · Must possess good communication, telephone and typing/computer skills (including Microsoft Word and Excel)
Added 2 mins ago
Transportation Manager
US Foods, Inc.
Fairburn, GA
Manager, Transportation will ensure a Transportation department culture focused on people, safety, service, and cost through meaningful engagements with drivers, best in-class service to…
Added 2 mins ago
Night Warehouse Manager - $8,000 Sign-On
US Foods, Inc.
Salem, VA
On day shift, designate dock locations for inbound carriers
Added 2 mins ago
Day Warehouse Manager
US Foods, Inc.
Alcoa, TN
On day shift, designate dock locations for inbound carriers
Added 2 mins ago
Territory Manager - Idaho Falls
US Foods, Inc.
Idaho Falls, ID
Join Our Team as a Territory Manager – Where Passion Meets Opportunity!
Added 2 mins ago
Facility Maintenance Manager
US Foods, Inc.
Alcoa, TN · Knoxville, TN
The Manager, Facility Operations is responsible for the safe, efficient, and compliant operation of all facility, domicile and hub functions and systems, including general maintenance,…
Added 2 mins ago
CC
C.E.A. (Level C), Deputy Director of Dispute Resolution
California Civil Rights Department
United States
- $10,349 to $21,370 USD / month
All applicants must possess the knowledge and abilities, and any other requirements, described in this announcement · State civil service employees must possess essential general qualifications including integrity, initiative, dependability, good judgment,
Added 2 mins ago
RC
Dock Supervisor
R+L Carriers
Colonial Heights, VA
- $68,000 to $85,000 USD / year
Candidates must have proven basic leadership experience · Must have the ability to lead in a fast-paced environment
Added 3 mins ago
FT Direct Support Professional
FUTURES COMMUNITY SUPPORT SERVICES INC
Towanda, PA
…areas of personal care, medication managements, and crisis…

CareSource Management Services LLC

Manager, Utilization Management

Remote, United States

Apply on caresource.wd1.myworkdayjobs.com About employer

Applications open in a new tab.

Job details

Pay: $83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.
Posting language: English
Posted: Nov 10, 2026

Original job description

Job Summary:

The Manager, Utilization Management is responsible for the oversight of all utilization management activities ensuring consistency of services and achievement of utilization targets.

Essential Functions:

Assist in coordination and management of the pre-determination process of medical and dental services; ensure the consistent application of criteria for authorization decision, and that decisions to deny or reduce services are made by a health care professional who has appropriate clinical expertise
Assist in the development of integrated service delivery to members and oversee utilization management data and processes to maintain industry standards and practices including decisions within allowable timeframes
Interact with providers and staff to manage benefits aligned with state-based regulations, NCQA and/or URAC regulations, and CareSource policies
Review and revise workflows to maximize efficiencies
Monitor productivity and utilization trends
Oversee CQI activities and ensure audits and staff feedback occur at regular intervals
Regularly report all utilization management regulatory requirements
Ensure compliance with and reporting of all regulatory requirements
Maintain all utilization management reporting and trend data
Analyze under and over utilization information for impact on member quality of care and outcomes and formulate recommendations based on data
Develop, maintain and update all departmental policies and procedures; ensure notices of adverse action are provided in accordance with required regulations
Audit predetermination requests, cases for documentation and interrater reliability per CareSource policy
Act as liaison with other departments to assist with research and intervention
Perform any other job related instructions, as requested

Education and Experience:

Associate’s Degree in Nursing is required and Bachelors of Science in Nursing (BSN) is preferred
Minimum of five (5) years of clinical experience is required
Minimum of five (5) years of experience in one of the following is required: case management, utilization management, and/or quality improvement
Two years of utilization management experience is preferred
Managed care experience is preferred

Competencies, Knowledge and Skills:

Beginning Excel, Word and PowerPoint experience
Experience in data analysis and trending
Knowledge of utilization management standards and practices
Communication skills
Management and prior supervisory skills
Ability to work independently and within a team environment
Attention to detail
Familiarity of the health care field
Critical listening and thinking skills
Training/teaching skills
Strategic management skills
Negotiation skills/experience
Proper grammar usage
Change resiliency
Technical writing skills
Time management skills
Proper phone etiquette
Customer service oriented
Decision making/problem solving skills
Leadership experience and skills

Licensure and Certification:

Current, unrestricted licensure in state of practice as a Registered Nurse (RN) is required

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary Organization Level Competencies

Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Brand=CareSource

Apply on caresource.wd1.myworkdayjobs.com About employer

More about this job

Skills

Regulatory compliance
Reporting
Documentation
Research
Case management
Microsoft Excel
Microsoft Word
Microsoft PowerPoint
Data analysis
Communication skills
Work independently
Attention to detail
Teaching
Negotiation
Technical writing
Time management
Customer service
Decision making
Problem solving
Leadership
RN

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Work requirements

Jobs in the United States