• Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …Contract to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Team: Fast paced, Interactive team… more
    US Tech Solutions (07/31/25)
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  • Registered Nurse Utilization Review…

    LifePoint Health (Louisburg, NC)
    …Case Management Department to facilitate timely discharge planning.. Reports to: Director , Case Management What we offer Fundamental to providing outstanding ... Registered Nurse (RN) Utilization Review Job Type: Full Time | Day...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate use of… more
    LifePoint Health (08/09/25)
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  • Utilization Review Clinician - EST/CST…

    Monte Nido (Miami, FL)
    …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - EST or CST hours** **Monte ... to provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting daily administrative and… more
    Monte Nido (06/21/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (08/02/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is responsible for...enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management more
    Brockton Hospital (06/13/25)
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  • Nursing Director , Administration…

    The County of Los Angeles (Los Angeles, CA)
    NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) Apply  NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Salary $163,996.80… more
    The County of Los Angeles (06/05/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... + Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, site… more
    Sharp HealthCare (07/19/25)
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  • Corporate Practice Manager

    Akin Gump Strauss Hauer & Feld LLP (New York, NY)
    …arrivals and transitions. Talent Management & Development + Work with Director to support workload management / utilization through ongoing communication ... Corporate Practice Manager in our Client Value & Practice Management department, reporting directly to the Director ...with partners, associates and staffing personnel. Review utilization reports and raise productivity issues as appropriate. +… more
    Akin Gump Strauss Hauer & Feld LLP (06/25/25)
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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …including managing Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a ... Director of Case Management **Position Summary**...design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead… more
    Stony Brook University (08/08/25)
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  • Director of Care Management

    Children's Mercy Kansas City (Kansas City, MO)
    …leadership, strategic planning, and oversight of daily operations of the case management department which includes utilization management , care progression ... children beyond the walls of our hospital. Overview The Director of Care Management responsible for providing...Partners with Revenue Cycle, Payor Relations, HIM and Risk Management in support of utilization management more
    Children's Mercy Kansas City (05/31/25)
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