• Nurse (Labor and Delivery)

    Defense Health Agency (Tacoma, WA)
    …responsiveness to emergencies; effectiveness of practice, patient management, bed utilization ; customer service and relations; open communications; and a safe ... assigned personnel, students and volunteers. Manages unit operations, personnel, bed utilization , and mission requirements. Completes 24 hour and ward status report… more
    Defense Health Agency (12/02/25)
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  • Senior Intake Coordinator

    Highmark Health (Buffalo, NY)
    …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses the verbal ... benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc.… more
    Highmark Health (12/02/25)
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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 the ... 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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  • RN Care Coordinator

    Dignity Health (Long Beach, CA)
    …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post acute ... AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure progression… more
    Dignity Health (11/30/25)
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  • Benefits Analyst

    Robert Half Finance & Accounting (Englewood, CO)
    …firm renewals. + Analyze current benefits, evaluating coverage, effectiveness, cost, plan utilization and trends. + Analyze all marketing and plan option responses, ... presentation and identifies what to include (ie; marketing results, utilization review, contribution strategy, benchmarking, financial reporting, etc.). Prepares… more
    Robert Half Finance & Accounting (11/30/25)
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  • Market CMO - South Carolina

    CenterWell (Columbia, SC)
    …care being provided meets appropriate standards and to ensure cost-effective utilization practices. . Oversee the development, revision, and implementation of ... expertise. . Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the...cost expectation of. . Identify trends of over- and under- utilization and implement actions plans to improve. . Direct… more
    CenterWell (11/28/25)
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  • Care Manager II, Acute

    Sutter Health (Modesto, CA)
    …care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
    Sutter Health (11/28/25)
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  • Division Director Clinical Pharmacy Services

    HCA Healthcare (Coral Springs, FL)
    …to include but not limited to: Clinical initiatives that impact drug utilization , clinical education and staff development, management of appropriate drug ... utilization , drug spend analysis, and quality improvement activities. Provides...plan that ensures positive patient outcomes and appropriate drug utilization + Analyze drug spend trends to identify areas… more
    HCA Healthcare (11/27/25)
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  • Referral Clerk

    Katmai (Fort Carson, CO)
    …management. Analyze data collected and prepare reports describing resource utilization patterns. Disseminate information to government members of collaborative teams ... network/outside providers and ancillary healthcare workers. + Apply principles of utilization review (UR) and utilization management (UM) in processing… more
    Katmai (11/26/25)
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  • Regional Case Manager

    NHS Management, LLC (Tuscaloosa, AL)
    …to facilities on Medicare eligibility, certification, coverage questions, documentation and utilization and provides training to facility staff as indicated. + ... Reviews Part B therapy utilization and assists facilities with utilization of Part B benefits for residents, along with nursing restorative programs. + Partners… more
    NHS Management, LLC (11/26/25)
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