• Manager , Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of … more
    Commonwealth Care Alliance (05/21/25)
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  • Utilization Review Case Manager

    Covenant Health (Nashua, NH)
    …and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory learning ... the patient is to receive services. + Perform ongoing evaluation and critical analysis of the patient's progress to...New Hampshire required + Minimum of five years broad clinical experience preferred + Case management and/or Utilization more
    Covenant Health (07/30/25)
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  • Utilization Management Reviewer

    Commonwealth Care Alliance (Boston, MA)
    Utilization Management Reviewer reports to the Utilization Management Manager . * Conducts timely clinical decision review for services requiring prior ... Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation more
    Commonwealth Care Alliance (07/31/25)
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  • Observation Utilization Review RN

    Trinity Health (Fort Lauderdale, FL)
    clinical experience is required.** Recent experience in case management, utilization review, discharge planning, ongoing monitoring and evaluation of patient ... * Communicates with physicians regarding appropriate setting for patient care * Initiates clinical review in Epic and notifies PAS to start the notification process… more
    Trinity Health (08/02/25)
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  • Supervisor, Assistant Clinical

    Guthrie (Sayre, PA)
    …support staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within ... the Guthrie Robert Packer Hospital. May be assigned to special projects per Clinical Manager / Director consistent with strategic, fiscal, and operational… more
    Guthrie (06/11/25)
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  • RN Clinical Manager , Home Health

    CenterWell (Marietta, GA)
    **Become a part of our caring community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in their homes by ... providing health and personal services; supporting patients and their families. The Clinical Manager , Home Health Nursing works within specific guidelines and… more
    CenterWell (07/25/25)
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  • Clinical Case Manager Behavioral…

    CVS Health (Arlington, TX)
    …and more compassionate. And we do it all with heart, each and every day. ** Clinical Case Manager Behavioral Health** **Position Summary** This is a remote role, ... Dallas, Texas as well as the surrounding areas. The Clinical Case Manager utilizes advanced clinical...with their provider in healthcare decision-making. + Analyzes all utilization , self-report and clinical data available to… more
    CVS Health (08/01/25)
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  • Clinical Case Manager Behavioral…

    CVS Health (Charleston, WV)
    …counties: Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane, Webster. The Clinical Care Manager BH utilizes advanced clinical judgment ... participate with their provider in healthcare decision-making. o Analyzes all utilization , self-report, and clinical data available to consolidate information… more
    CVS Health (08/01/25)
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  • Clinical Resource Manager

    HCA Healthcare (Nashville, TN)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Resource Manager with HealthTrust Supply Chain you can be a ... in our organization. We are looking for an enthusiastic Clinical Resource Manager to help us reach...of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation more
    HCA Healthcare (06/21/25)
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  • Clinical Manager , RN

    Erickson Living (Hingham, MA)
    Location: Linden Ponds by Erickson Senior Living Join our team as the Clinical Manager is an active member of the clinical leadership team who is responsible ... delivery of safe and effective person-centered care in their assigned neighborhood. The Clinical Manager will also facilitate, precept, and mentor staff to grow… more
    Erickson Living (07/19/25)
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