• Coordinator of Pharmacy Benefits - Fulltime…

    Henry Ford Health System (Troy, MI)
    …(October 2004) Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code: Not Applicable ... Additional Details This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform… more
    Henry Ford Health System (12/08/25)
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  • Utilization Management RN Weekender

    Grace Hospital (Morganton, NC)
    …and their families ." THE POSITION Join our dynamic healthcare team as a Utilization Management RN Weekender, where you will play a vital role in ensuring the ... effective and efficient use of healthcare services. Leverage your clinical expertise to assess patient needs, coordinate care, and collaborate with multidisciplinary teams to optimize patient outcomes. Be a part of a supportive environment that values your… more
    Grace Hospital (12/06/25)
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  • Care Management and Utilization Management…

    CentraCare (St. Cloud, MN)
    …Full time Responsible for providing administrative support to Care Management and Utilization Review departments. Functions as a communication link for the team and ... assists with coordinating discharge activity for hospitalized patients. Coordinates the payor contact process to assure required and requested information is provided. Utilizes a variety of professional skills such as computer/word processing and database… more
    CentraCare (12/06/25)
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  • RN Admissions Coordinator/ Utilization

    PeaceHealth (Eugene, OR)
    **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... salary range for this job opening at PeaceHealth is $47.34 - $71.00. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.… more
    PeaceHealth (12/05/25)
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  • Utilization Management Coordinator

    Integra Partners (Troy, MI)
    …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES + Monitor ... incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes + Verify eligibility and claim history in proprietary claims platform + Verify all necessary documentation has been submitted with authorization requests +… more
    Integra Partners (11/28/25)
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  • RN Case Manager - Utilization Review

    Prime Healthcare (Lynwood, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn-case-manager utilization -review/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. ... Francis Medical Center LocationUS-CA-Lynwood ID2025-236088 CategoryRN Position TypeFull Time ShiftDays Job TypeNon-Exempt more
    Prime Healthcare (11/27/25)
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  • Pharmacy Analyst - 40 hrs/wk - Utilization

    Henry Ford Health System (Troy, MI)
    …with customers. Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code: Not Applicable ... Additional Details This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform… more
    Henry Ford Health System (11/26/25)
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  • Utilization Management Operations Trainer…

    Rady Children's Hospital San Diego (San Diego, CA)
    …Manager, the UM Operations Trainer's primary job function is to support Utilization Management operations by training non-clinical staff on how to successfully ... perform any non-clinical tasks. This includes, but is not limited to, initial authorization processing (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering the… more
    Rady Children's Hospital San Diego (11/22/25)
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  • Utilization Management Nurse - LPN/LVN

    Integra Partners (Troy, MI)
    …experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ... role in collaborating with our Medical Director to perform benefit and medical necessity reviews and appeals within an NCQA-compliant UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse's responsibilities include… more
    Integra Partners (11/21/25)
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  • Social Worker II - Utilization Management

    Prime Healthcare (Redding, CA)
    …(https://careers-primehealthcare.icims.com/jobs/222168/social-worker-ii utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... FacilityShasta Regional Medical Center LocationUS-CA-Redding ID2025-222168 CategoryClinical Professional Position TypeFull Time ShiftDays Job TypeNon-Exempt more
    Prime Healthcare (11/20/25)
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