• Physician Opportunity

    Summit Medical Consultants LLC (Pueblo, CO)
    …care, and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high ... Supports practice budgetary targets while maintaining standards of care. Participates in utilization and care management processes to ensure high quality,… more
    Summit Medical Consultants LLC (12/01/25)
    - Related Jobs

  • Case Management Coordinator RN

    Catholic Health Initiatives (Lisbon, ND)
    …+ 3-5 year's current clinical experience in acute care settings + Prior Case Management / Utilization Review **Where You'll Work** CHI Lisbon Health is a ... **Job Summary and Responsibilities** As a Case Management Professional, you will be a pivotal coordinator...planning team. + Documents discharge planning as an ongoing review . + Monitors and coordinates swing bed referrals. +… more
    Catholic Health Initiatives (12/19/25)
    - Related Jobs

  • Director, Lab Stewardship and Test Optimization

    Bon Secours Mercy Health (Cincinnati, OH)
    …cost per test for both in-house and referral tests. + Develop and chair a utilization management review committee and partner with the prior authorization ... team. + Review high-cost and high-volume referral tests for clinical appropriateness...and problem-solving skills. + Excellent communication, collaboration, and project management skills. + Proven ability to influence physician behavior… more
    Bon Secours Mercy Health (12/13/25)
    - Related Jobs

  • Behavioral Health Medical Director - Psychiatrist…

    Elevance Health (Norfolk, VA)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience.… more
    Elevance Health (01/09/26)
    - Related Jobs

  • Crisis Intervention Specialist - Warren Campus

    St. Luke's University Health Network (Phillipsburg, NJ)
    …clinical mental health/crisis intervention experience required. Previous experience with case management / utilization review and managed care models ... who may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and… more
    St. Luke's University Health Network (01/13/26)
    - Related Jobs

  • Patient Logistics RN

    CommonSpirit Health (Rancho Cordova, CA)
    …responsibilities leading up to or including supervisory role + Experience in Utilization Management , Case Management or Care Coordination, Managed ... performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Core Duties:** + Compiles data… more
    CommonSpirit Health (12/29/25)
    - Related Jobs

  • Placement Liaison

    Banner Health (Mesa, AZ)
    …both internal and external customers. Manages data as related to operations. Performs Utilization Management functions as required by facility CORE FUNCTIONS 1. ... and advanced technology that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of the top 50 busiest… more
    Banner Health (12/22/25)
    - Related Jobs

  • Crisis Intervention Specialist - Upper Bucks…

    St. Luke's University Health Network (Quakertown, PA)
    …clinical mental health/crisis intervention experience required. Previous experience with case management / utilization review and managed care models ... who may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and… more
    St. Luke's University Health Network (12/19/25)
    - Related Jobs

  • Senior Data Scientist

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Blue Cross Blue Shield of MN! This role is a key contributor to our Utilization Management team, helping to shape smarter, data-driven decisions that improve how ... degree. * Experience with health care data (focus on Utilization Management a plus) * Experience with...discover more about what we have to offer, please review our benefits page. Role Designation Hybrid Anchored in… more
    Blue Cross and Blue Shield of Minnesota (12/10/25)
    - Related Jobs

  • Clinical Coordinator Patient Logistics RN

    CommonSpirit Health (Rancho Cordova, CA)
    …leading up to or including supervisory role highly preferred + Experience in Utilization Management , Case Management or Care Coordination, Managed Care ... and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Accountabilities:** + Compiles data for… more
    CommonSpirit Health (11/26/25)
    - Related Jobs