• Medical Director, Medical Oncology Performance

    Evolent (Pittsburgh, PA)
    …medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation. **Core ... Responsibilities** + **Team Leadership & Performance Management ** + Lead and manage a team of medical oncologists responsible for reviewing oncology cases. +… more
    Evolent (12/03/25)
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  • Director GBD Special Programs Services - LTSS

    Elevance Health (Hendersonville, TN)
    …related field, including prior management experience and clinical, quality, and/or utilization management experience in a managed care setting; or any ... Directs and oversees program operations in support of corporate and health plan management in execution of clinical service delivery. + Monitors national and local… more
    Elevance Health (12/03/25)
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  • RNAC / Director of Care Coordination (RN)

    Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
    …Degree in nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
    Diversicare Healthcare Services & Diversicare Ther (12/02/25)
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  • Human Geographer (Mid-Level) - TS/SCI

    Wiser (St. Louis, MO)
    …ArcGIS Pro software tools in the creation, attribution, schema development and utilization , management , and geo-referencing of data. + Experience in geo-enabling ... shall use an understanding of geography, research, GIS, and data conflation and management skills to produce the broad array of human geography products including… more
    Wiser (12/02/25)
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  • Newborn Screening Program Community…

    UCLA Health (Los Angeles, CA)
    …care experience or knowledge of maternal child health agencies. + Case management / utilization management , health education and/or discharge planning ... CL will offer some administrative support and will maintain case management activities for non-positive NBS results and data verifications. Primary responsibilities… more
    UCLA Health (11/27/25)
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  • Discharge Planner - Crisis Stabilization Unit

    Prime Healthcare (Chula Vista, CA)
    …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state submission… more
    Prime Healthcare (11/27/25)
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  • Director, Surgical Services - La Jolla Memorial…

    Scripps Health (San Diego, CA)
    …overall administration, operation, direction, design, financial performance, human resource management , regulatory compliance, quality, utilization management ... in La Jolla. This is an exempt and salaried position eligible for the Management Incentive Compensation Plan (MICP) at the Director level.* *Why Scripps Memorial La… more
    Scripps Health (11/21/25)
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  • Medical Director, Medicare Grievances

    Humana (Honolulu, HI)
    …and interpretation skills with prior experience leading teams focusing on quality management , utilization management , discharge planning and/or home health ... on continuously improving consumer experiences **Preferred Qualifications** + Medical management experience, working with health insurance organizations, hospitals and… more
    Humana (11/19/25)
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  • RN Case Manager - Emergency Department

    Trinity Health (Philadelphia, PA)
    …nursing required. + Active PA RN License required. + Three (3) years of utilization management or case management experience, including emphasis on discharge ... planning. + Case Management certification from an accredited organization preferred **We offer a competitive salary and comprehensive benefits including:** +… more
    Trinity Health (11/13/25)
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  • Care Review Clinician (BH Licensed)

    Molina Healthcare (Louisville, KY)
    …with multidisciplinary teams to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work collaboratively ... with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit. Required Qualifications * At least 2 years… more
    Molina Healthcare (11/09/25)
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