• UM Coordinator Supervisor

    Integra Partners (Troy, MI)
    The Utilization Management (UM) Coordinator Supervisor oversees the day-to-day operations and performance of the UM Coordinator team. This position ensures ... required; bachelor's degree preferred. + minimum of 2 years of experience in Utilization Management (UM), managed care, or healthcare operations, preferably in a… more
    Integra Partners (10/16/25)
    - Related Jobs
  • Utilization Management Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
    Excellus BlueCross BlueShield (10/07/25)
    - Related Jobs
  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...+ Preceptor Pay - $2.50 per hour + House Supervisor Pay - $4.00 per hour + Charge Nurse… more
    Ventura County (09/21/25)
    - Related Jobs
  • Registered Nurse (RN) Utilization

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
    Commonwealth Care Alliance (10/02/25)
    - Related Jobs
  • Behavioral Health Utilization Review Nurse

    Actalent (Fort Lauderdale, FL)
    Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... Prepare and present reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental Health + Clinical review… more
    Actalent (10/15/25)
    - Related Jobs
  • Behavioral Health Utilization Review Nurse

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… more
    Actalent (10/10/25)
    - Related Jobs
  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of ... payment related activities. Position Responsibilities: + Prepares necessary documentation for utilization management and appeals processes, performs data … more
    Catholic Health Services (09/09/25)
    - Related Jobs
  • Utilization Management Coordinator

    Saint Francis Health System (Tulsa, OK)
    …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... Reviews eligibility and benefits of patients, matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area… more
    Saint Francis Health System (10/08/25)
    - Related Jobs
  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
    Helio Health Inc. (10/07/25)
    - Related Jobs
  • Utilization Management RN Traveler

    Ascension Health (Baltimore, MD)
    …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for resources and removal of barriers. + Maintain ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan.… more
    Ascension Health (10/17/25)
    - Related Jobs