• Manager Behavioral Health Services

    Elevance Health (Las Vegas, NV)
    …center The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management (BH CM) ... and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate… more
    Elevance Health (12/24/25)
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  • Case Manager

    Trinity Health (Mason City, IA)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** The Utilization Review Case Manager responsibilities include case screening, insurance approval, ... Works directly with members of care team to effectively ensure appropriate acute utilization management + Interacts with outside review agencies and payors to inform… more
    Trinity Health (12/19/25)
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  • Chief Medical Officer, Health Plan (Reside in NV)

    Molina Healthcare (Reno, NV)
    …development and execution of the Plan's disease management, case management, utilization management, and care management programs. Oversees the development of the ... of care management programs, including such programs as Quality Improvement, Utilization Management, Care Management, Predictive Modeling, and Disease Management. +… more
    Molina Healthcare (12/13/25)
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  • Care coordinator

    ChenMed (Lauderhill, FL)
    …leaders, external clients and HMO to establish, maintain and support outpatient utilization management in PMR and delegated utilization management in ChenMed ... + Provide insights to the PMR team and Network Director and work with them to take action. +...**_Other responsibilities may include:_** + Drive the current delegated/non-delegated utilization management model to a sustainable and reproducible one… more
    ChenMed (12/05/25)
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  • Transitional Care Manager, Behavioral Health

    CVS Health (Oklahoma City, OK)
    …member-centered care; preventing avoidable readmissions; and managing efficient resource utilization . **We are recruiting TCMs who would be available to ... follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records...in regular meetings with CVS Health regional leaders, Program Director , Project Manager and other Transitional Care Managers on… more
    CVS Health (11/27/25)
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  • Complex Case Manager

    Beth Israel Lahey Health (Burlington, MA)
    …difficult and complex discharges. Under the general direction of the Manager and Director of the Case Management, and within the Lahey Clinic Professional Practice ... Practice and Code of Ethics, the Case Manager performs duties relative to utilization and discharge planning. The Complex Case Manager acts as an educational… more
    Beth Israel Lahey Health (11/21/25)
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  • Manager Care Management - UNC Disposition Resource…

    UNC Health Care (Chapel Hill, NC)
    …Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social Workers, Clinical Authorization Specialists, and ... of quality consistent with organizational standards. Reports to the Assistant Director of Clinical Care Management. Responsibilities: 1. Assists Assistant … more
    UNC Health Care (11/22/25)
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  • RN Case Manager - Value Based Service Org - Full…

    University of Southern California (Alhambra, CA)
    …The role integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of ... Coordinators. 4. Makes appropriate referrals to supervisor or Medical Director , communicating accurate clinical information. 5. Participates in guideline (MCG… more
    University of Southern California (11/19/25)
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  • Scheduler

    HCA Healthcare (Houston, TX)
    …duties as assigned by the Scheduling Supervisor. + Under guidance of the Director and Assistant Director , determines appropriate priorities for activities based ... large volume of work demands in collaboration with the Director , Assistant Director and other hospital personnel...Applies knowledge of rehab scheduling procedures to ensure maximum utilization of available staff and equipment. + Schedules and… more
    HCA Healthcare (12/23/25)
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  • RN Clinical Manager

    CenterWell (Westbury, NY)
    …of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. + ... objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations. + Participates in the interviewing, hiring,… more
    CenterWell (12/20/25)
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