• Medical Director (New Mexico)

    Molina Healthcare (NM)
    …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
    Molina Healthcare (12/18/25)
    - Related Jobs
  • Clinical Transitions Specialist RN - Case…

    Carle Health (Normal, IL)
    utilization issues in appropriate locations, including but not limited to: case management / utilization review software and the multidisciplinary plan of ... Case Manager (ACM) within 3 years - American Case Management Association (ACMA)American Case Management Association (ACMA), Education: Bachelor's Degree:… more
    Carle Health (11/26/25)
    - Related Jobs
  • Contracts & Procurement Specialist (Business…

    State of Massachusetts (MA)
    …projects in a timely and confidential manner. *Position Summary* Reporting to the Manager of Contracts, the Business Management Specialist will work to ensure ... by the manager to support overall team objectives. COMMBUYS Activities/Bid Management : * Monitor and support procurement activities in COMMBUYS on behalf of… more
    State of Massachusetts (12/13/25)
    - Related Jobs
  • Medical Management Specialist I

    Elevance Health (IN)
    …Prepares reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation ... area to refer or assign case ( utilization management , case management , QI, Med Review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/18/25)
    - Related Jobs
  • Medical Management Specialist I

    Elevance Health (Washington, DC)
    …Prepares reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation ... area to refer or assign case ( utilization management , case management , QI, Med Review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/13/25)
    - Related Jobs
  • Case Management Representative…

    Houston Methodist (Houston, TX)
    …case management and social work department to facilitate efficient utilization of resources and discharge planning including referrals management , ... At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the… more
    Houston Methodist (11/08/25)
    - Related Jobs
  • Care Management Navigator I

    Rush University Medical Center (Chicago, IL)
    …Division. The Care Management Navigator may contribute to transitional care planning, utilization review , and/or service line growth & outreach efforts for a ... Rush Medical Center Hospital: Rush University Medical Center Department: Ambulatory Care Management **Work Type:** Full Time (Total FTE between 0.9 and 1.0)… more
    Rush University Medical Center (11/03/25)
    - Related Jobs
  • Care Management Assistant

    Intermountain Health (Ogden, UT)
    …ongoing communication. + Requests and retrieves medical records from Health Information Management for retrospective utilization review or quality assurance. ... **Job Description:** The Care Management Assistant - Medical Units, is a patient-focused...accordance with contractual requirements and communicates with care managers, utilization review RNs, revenue cycle, and payers… more
    Intermountain Health (12/18/25)
    - Related Jobs
  • Case Management Supervisor

    University of Utah Health (Salt Lake City, UT)
    …the accurate reporting of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and ... This position is responsible for the day to day management of the Case Management Department. Plans,...analyzes Case Manager quality of service and utilization statistics.… more
    University of Utah Health (12/24/25)
    - Related Jobs
  • Director, Comprehensive Care Management

    Baylor Scott & White Health (Dallas, TX)
    …or related field preferred. Master's degree preferred. 2. 5+ years of experience in case management , social work, utilization review , or related field. 3. 1+ ... , social services, coordination of patient care, patient access, utilization management , and discharge planning. Directs the...larger, more complex organization or functional area than a manager . Often has one or more managers or supervisors… more
    Baylor Scott & White Health (11/15/25)
    - Related Jobs