• Regional Medical Director , Care…

    UPMC (Pittsburgh, PA)
    The Regional Medical Director , CC/DP and Utilization Review , provides clinical and management leadership across multiple hospitals within the region. ... hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management ...care organizations, providers, and payers to address benefit coverage, utilization review , and quality assurance. + Promote… more
    UPMC (07/11/25)
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  • Temporary, Utilization Review

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... Serve as the lead for CCA's Utilization Review functions working closely with other medical management...+ Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed… more
    Commonwealth Care Alliance (08/20/25)
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  • RN- Utilization Review

    Ascension Health (Milwaukee, WI)
    **Details** + **Department:** Utilization Management + **Schedule:** Full Time, Partially Remote + **Hospital:** Multiple Ascension Hospitals in WI + ... **Responsibilities** Provide strategic direction and oversight of the day-to-day operation of utilization management function within the insurance plan. + Ensure… more
    Ascension Health (08/08/25)
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  • Program Mgr UR/Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …resource utilization to Director and/or Assistant Director of Utilization Review /Case Management . + Maintains a documentation system of all ... ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical… more
    UTMB Health (08/01/25)
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  • Director Utilization Mgmt (Do…

    Wellpath (Lemoyne, PA)
    …**How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review , case management , quality ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
    Wellpath (08/08/25)
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  • Director Of Nursing / DON / 10k Sign On

    BrightSpring Health Services (Sacramento, CA)
    …days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
    BrightSpring Health Services (08/16/25)
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  • Deputy Procurement Director (Program…

    State of Colorado (Denver, CO)
    Deputy Procurement Director (Program Mgmt III) - Denver...appeal with the State Personnel Board or request a review by the State Personnel Director . An ... Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4829525) Apply  Deputy Procurement Director (Program Mgmt III) - Denver Salary $117,600.00… more
    State of Colorado (08/22/25)
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  • Med Mgmt Clinician Sr (US)

    Elevance Health (Las Vegas, NV)
    …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
    Elevance Health (07/23/25)
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  • Supv Regional Care Mgmt - Integrated Care…

    Sharp HealthCare (San Diego, CA)
    …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
    Sharp HealthCare (07/09/25)
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  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
    Alameda Health System (08/08/25)
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