• Program Director

    WestCare Foundation (San Diego, CA)
    …staff development, education and training activities; + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the ... Salary Position Type Full Time Education Level 4 Year Degree Category Management Description Position Summary: Person in this position will be responsible for… more
    WestCare Foundation (10/24/25)
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  • Director , Quality Safety & Risk Prevention…

    Vanderbilt University Medical Center (Lebanon, TN)
    …Present and justify a proposed budget (operating and capital expenditure) to a management review committee * Evaluate organizational functions and structures to ... explain/clarify problems, issues or requests. * Participate in periodic management meetings to keep top management informed...best determine the allocation and utilization of resources * Analyze and evaluate budget variance… more
    Vanderbilt University Medical Center (11/21/25)
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  • Director , Clinical Payment Integrity

    Centene Corporation (Jefferson City, MO)
    …**Position Purpose:** + Oversee post pay/retrospective overpayment and inappropriate utilization reviews through audit programs. Provide guidance and set policies ... clinical audits to ensure accurate and timely payment of claims. + Interpret review results, develop action plans and present findings to senior management more
    Centene Corporation (12/06/25)
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  • Director Of Jcc

    City of New York (New York, NY)
    …transition from shelter into appropriate permanent housing. DHS is responsible for management of over 200 facilities, which mainly are individual and family shelters ... and DOB, to ensure strategic alignment and effective resource utilization . - Ensure robust field supervision systems are in...to address client needs and develop innovative solutions. - Review and approve case summaries and reports for special… more
    City of New York (09/19/25)
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  • Director of Customer Technical Services

    Amcor (Evansville, IN)
    …CTS engagement and develop alternatives should immediate support not be available. 4.1.2 Review CTS Representative Trip Reports. 4.1.3 Assure the team is capable and ... of quality systems 5.3 Experience in plastics industry 5.4 Strong project management and analytical skills with history of delivering solutions 5.5 Confident,… more
    Amcor (11/25/25)
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  • Director Post Acute Partnerships (External…

    Genesis Healthcare (NM)
    … experience. 5. Experience in business/development preferred. 6. Prior experience in utilization review or discharge planning preferred. 7. Certifications: CCM, ... LPN or CIRS preferred. Benefits *Variable compensation plans *Tuition, Travel, and Wireless Service Discounts *Employee Assistance Program to support mental health *Employee Foundation to financially assist through unforeseen hardships *Diverse, Equitable, and… more
    Genesis Healthcare (09/23/25)
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  • Per Diem RN - Case Management - Sharp…

    Sharp HealthCare (La Mesa, CA)
    …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as… more
    Sharp HealthCare (12/06/25)
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  • RN/Case Manager-MSH-Case Management

    Mount Sinai Health System (New York, NY)
    …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case… more
    Mount Sinai Health System (12/11/25)
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  • Manager of Care Management - RN

    Community Health Systems (Valparaiso, IN)
    Management is responsible for the planning, coordination, and oversight of care management services, including utilization review , discharge planning, and ... efficiently, effectively, and in compliance with organizational standards. + Oversees utilization review and discharge planning processes to ensure… more
    Community Health Systems (10/14/25)
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  • Senior Clinical Review Nurse…

    Centene Corporation (Jefferson City, MO)
    …are seeking candidates with strong experience in payment integrity and utilization review .** **Education/Experience:** Requires Graduate from an Accredited ... knowledge of Medicare and Medicaid regulations preferred. Strong knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
    Centene Corporation (12/07/25)
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