• Executive System Director of Utilization

    UNC Health Care (Morrisville, NC)
    …unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible for ... designing, implementing, and standardizing utilization management functions across a large healthcare system, including a complex academic health system and multiple… more
    UNC Health Care (10/29/25)
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  • Utilization Management Nurse

    CVS Health (Austin, TX)
    …And we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can ... department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to… more
    CVS Health (01/01/26)
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  • Clinical Supervisor Utilization Review…

    Martin's Point Health Care (Portland, ME)
    …+ 3+ years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting + Leadership and/or ... Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, organizational… more
    Martin's Point Health Care (12/23/25)
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  • Director of Case Management - Utilization

    Prime Healthcare (Inglewood, CA)
    …outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered ... of Case Management to lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers, and Clinical Coordinators. This leader will oversee all… more
    Prime Healthcare (12/24/25)
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  • Utilization Management Clinical Consultant…

    CVS Health (Phoenix, AZ)
    …AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that includes Arizona.) Candidate may have opportunities ... the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a...are not permitted. **Required Qualifications** + Active, unrestricted Arizona RN license or a compact license that includes Arizona.… more
    CVS Health (12/13/25)
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  • Utilization Management Manager

    State of Indiana (Indianapolis, IN)
    Utilization Management Manager Date Posted: Jan 6, 2026 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review, clinically… more
    State of Indiana (01/05/26)
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  • Utilization Management Coordinator (H)

    Saint Francis Health System (Tulsa, OK)
    …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal… more
    Saint Francis Health System (12/31/25)
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  • RN -Wound (H)

    SSM Health (Oklahoma City, OK)
    …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... + Participates in ministry and system-wide evaluation of resource utilization as it pertains to wound, ostomy, and continence...Or + Registered Nurse ( RN ) Issued by...Or + Registered Nurse ( RN ) Issued by Compact State State… more
    SSM Health (12/11/25)
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  • RN -Case Manager (H)

    SSM Health (St. Charles, MO)
    …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... in standard work. + May also be responsible for: utilization management process, ED case management process, admission process,...Registered Nurse ( RN ) - Missouri Division of Professional… more
    SSM Health (12/05/25)
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  • Per Diem RN - Case Management - Sharp…

    Sharp HealthCare (La Mesa, CA)
    …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...provides information to the department head as indicated. + Utilization review and utilization managementThe RN more
    Sharp HealthCare (12/06/25)
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