• 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...or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental… more
    Alameda Health System (08/08/25)
    - Related Jobs
  • RN System Director Utilization

    Tufts Medicine (Burlington, MA)
    … review and management . The position develops and leads the Utilization Management operations, strategy and implementation of the Utilization ... of Science in Nursing (BSN). 2.Massachusetts RN Licensure. 3. Current certification in case/ utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/Case… more
    Tufts Medicine (08/29/25)
    - Related Jobs
  • Medical Director Utilization

    AmeriHealth Caritas (Philadelphia, PA)
    ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management , ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical… more
    AmeriHealth Caritas (08/12/25)
    - Related Jobs
  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management more
    Prime Healthcare (08/26/25)
    - Related Jobs
  • Temporary, Utilization Review Medical…

    Commonwealth Care Alliance (Boston, MA)
    … will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
    Commonwealth Care Alliance (08/20/25)
    - Related Jobs
  • Utilization Management Medical…

    Elevance Health (Winston Salem, NC)
    ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... may be considered. The **Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid. May be responsible… more
    Elevance Health (08/29/25)
    - Related Jobs
  • Director of Utilization

    Insight Global (Boston, MA)
    Job Description Insight Global is sourcing for a Utilization Management Director to join a not-for-profit community based healthcare organization within the ... federal, state, and local regulatory guidelines. -Support the development of utilization management policy initiatives. -Support the development and… more
    Insight Global (08/20/25)
    - Related Jobs
  • Medical Director , Post-Acute Care…

    MVP Health Care (Tarrytown, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
    MVP Health Care (09/01/25)
    - Related Jobs
  • Medical Director Utilization

    Henry Ford Health System (Clinton Township, MI)
    GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at… more
    Henry Ford Health System (08/13/25)
    - Related Jobs
  • RN- Utilization Review Director for

    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)
    - Related Jobs