• Senior Director of Health Services…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Blue Shield of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan, Minnesota Career Area: Health ... us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for the design, strategic planning, evolution, and… more
    Blue Cross and Blue Shield of Minnesota (12/24/25)
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  • RN, Hospital Case Manager/ Utilization

    Baystate Health (Springfield, MA)
    …- Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager** is a registered nurse responsible ... and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers… more
    Baystate Health (12/19/25)
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  • Utilization Management

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
    Mount Sinai Health System (01/02/26)
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  • Discharge Planner - Utilization

    Prime Healthcare (Montclair, CA)
    …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/221097/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMontclair… more
    Prime Healthcare (12/30/25)
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  • Utilization Management

    Elevance Health (Latham, NY)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer ; and handles… more
    Elevance Health (12/31/25)
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  • Utilization Management Rep II

    Elevance Health (West Des Moines, IA)
    ** Utilization Management Representative II** **Location:** The selected candidate for this position must reside in Iowa. **_Virtual:_** This role enables ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer ; and handles… more
    Elevance Health (11/25/25)
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  • Clinical Registered Nurse - Utilization

    Cognizant (Salem, OR)
    …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' ... as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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  • Utilization Management Nurse

    Katmai (Fort Carson, CO)
    …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
    Katmai (12/18/25)
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  • Utilization Management

    Elevance Health (Columbus, GA)
    ** Utilization Management Representative III** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative III** is responsible for coordinating cases for… more
    Elevance Health (12/19/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (11/13/25)
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