• RN, Hospital Case Manager

    Baystate Health (Springfield, MA)
    …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... experience strongly preferred **Skills and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and… more
    Baystate Health (12/19/25)
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  • Manager , Organ Utilization

    LifeCenter Northwest (Bellevue, WA)
    …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
    LifeCenter Northwest (12/10/25)
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  • Manager of Clinical Documentation Integrity…

    Logan Health (Kalispell, MT)
    …Excellence. Logan Health is looking for an RN to lead the way as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review! This role is ideal ... workflows with clarity. What You'll Be Doing: As the Manager of CDI & Utilization Review, you...manner + Partnering with the Chief Medical Officer on utilization review initiatives, length of stay management ,… more
    Logan Health (01/01/26)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management more
    Helio Health Inc. (12/02/25)
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  • Utilization Review Specialist Nurse (RN)…

    Houston Methodist (Houston, TX)
    …payer requirements/issues, and eligibility for state, local, and federal programs + Comprehensive knowledge of utilization management , case management , ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
    Houston Methodist (11/02/25)
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  • Manager - Contracts & Utilization

    Ochsner Health (Jefferson, LA)
    …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
    Ochsner Health (12/05/25)
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  • Utilization Review Case Manager

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... to help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
    Dallas Behavioral Healthcare Hospital (10/30/25)
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  • RN Utilization Review - Case…

    Tenet Healthcare (Detroit, MI)
    …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
    Tenet Healthcare (12/03/25)
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  • Manager , Inpatient Pharmacist - Pharmacy…

    University of Rochester (Rochester, NY)
    …and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and management responsibilities for the pharmacy ... locations, and is intended to be a 'line manager ' level of responsibility, covering shifts typical of their...in hospital pharmacy administration + Graduate degree in business management (or another relevant field) Preferred ** KNOWLEDGE ,… more
    University of Rochester (11/12/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    … of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health ... Utilization Management Nurse Specialist RN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (12/20/25)
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