• Utilization Management

    Humana (Concord, NH)
    …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and… more
    Humana (10/10/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …Bachelor degree in a related field or at least one year experience in case management , discharge planning or nursing management ; 2. Experience and knowledge ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case-manager utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityWest… more
    Prime Healthcare (08/08/25)
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  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
    CVS Health (10/01/25)
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  • Case Manager (RN) - Utilization

    Prime Healthcare (San Dimas, CA)
    …care nursing experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS ... 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to… more
    Prime Healthcare (10/10/25)
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  • Clinical Utilization Management

    BrightSpring Health Services (Louisville, KY)
    Our Company PharMerica Overview The Clinical Utilization Management Pharmacistis responsible for providing data driven consultative services to clients that ... outcomes. The pharmacist works closely with Billing, Clinical Operations, Account Management and Sales to assure cost containment initiatives differentiate the… more
    BrightSpring Health Services (08/09/25)
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  • Registered Nurse - Utilization

    ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (09/13/25)
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  • RN- Utilization Management

    ERP International (Macdill AFB, FL)
    …is seeking a **Registered** ** Nurse (RN)** for a Full-Time position in ** Utilization Management ** at MacDill AFB, FL. Apply online today and discover more ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (09/18/25)
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  • Utilization Management Nurse

    Insight Global (Campbell, CA)
    …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Medi-Cal HMO lines of business - Health plan experience - Prior experience working with health plan portals more
    Insight Global (10/16/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
    CVS Health (10/15/25)
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  • Utilization Management Clinician…

    CVS Health (Frankfort, KY)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required to use a residential broadband… more
    CVS Health (10/08/25)
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