• Operations Manager - NPC, One Medical Operations

    Amazon (TX)
    …delivery and improve healthcare accessibility. You'll oversee the operations for the National Remote Primary Care (RPC) team managing remote providers across the ... monitor quality and customer experience, provide gap analysis and business review documents while working cross functionally throughout the organization to lead… more
    Amazon (10/18/25)
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  • Health System Specialist

    Veterans Affairs, Veterans Health Administration (Boise, ID)
    …will be, used by management teams for budget preparations, quality assurance and utilization review for programs that involve patient care. Prepares recurring ... and direct the development of major policies for computer utilization related to the core patient care activities and...of reports in preparation for outside and internal organizational review groups, as well as, veteran service organizations as… more
    Veterans Affairs, Veterans Health Administration (01/02/26)
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  • Medical Director - IP Claims Management

    Humana (Raleigh, NC)
    …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
    Humana (12/11/25)
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  • Clinical Case Manager Behavioral Health (Spanish…

    CVS Health (Harrisburg, PA)
    …and English **Preferred Qualifications** + Crisis intervention skills preferred Managed care/ utilization review experience preferred + Case management and ... discharge planning experience preferred + Managed care/ utilization review experience preferred **Education** Masters Degree in Social Work or Counseling required… more
    CVS Health (11/14/25)
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  • Behavioral Health - Case Manager

    Texas Health Resources (Arlington, TX)
    …or chemical dependency experience Required and * 6 Months in case management or utilization review Required * Prior experience with EPIC EMR Licenses and ... are Better + Together_ Work location: Texas Health Resources - Behavioral Health, Remote Work hours: Full-time (40hours) Monday - Friday 9:00AM - 5:00PM Education *… more
    Texas Health Resources (01/02/26)
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  • Medical Reviewer LPN

    Health Care Service Corporation (Chicago, IL)
    …reviews in accordance with the medical contract and regulations, medical criteria, utilization review , and quality of care. **JOB REQUIREMENTS** **:** + ... not required to obtain multi-state licenses. **PREFERRED JOB REQUIREMENTS** **:** + Utilization review or utilization management experience **Telecommute:**… more
    Health Care Service Corporation (12/16/25)
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  • Intake Coordinator

    Highmark Health (Buffalo, NY)
    …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... for the member, and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review . Ensures all accurate… more
    Highmark Health (12/02/25)
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  • Nurse Case Manager I

    International Medical Group (Indianapolis, IN)
    …efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the ... in good standing in Indiana. + Location: Hybrid or Remote working options. + Corporate office is in Indianapolis,...PREFERRED SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or… more
    International Medical Group (11/16/25)
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  • Inventory Manager

    WMCHealth (Valhalla, NY)
    …(https://pm.healthcaresource.com/cs/wmc1/#/preApply/31093) Internal Applicant link Job Details: Onsite/ No remote work Job Summary: The Inventory Manager is ... and logistics framework. Responsibilities: . Leads the development, implementation and review of an optimal inventory strategy to ensure the appropriate balance… more
    WMCHealth (11/13/25)
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  • Associate Head (Vice Chief) for Clinical Affairs,…

    University of Colorado (Aurora, CO)
    …"operations playbook"o **Access/Scheduling:** Optimize template design, room utilization , referral standards, subspecialty triage, new/return ratios, ... PTO coverage.o **Throughput/Flow:** Enhance ED-to-unit flow, CCU and step-down utilization , discharge timing, readmission pathways, and navigator support.o **Procedural… more
    University of Colorado (10/26/25)
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