• Operations Management Area Director

    Sevita (Rancho Cordova, CA)
    …us today, and experience a career well lived. **$70,000.00 a year** **Operations Management Area Director** Everybody needs a job but only extraordinary people work ... Responsible for the financial performance of the area business unit, review financial statements, oversee purchasing, assure billing compliance, and documentation. +… more
    Sevita (10/15/25)
    - Related Jobs

  • Director of Clinical Services

    Marrakech, Inc. (Woodbridge, CT)
    … Review Committee (PRC), Human Rights Committee (HRC), and Utilization Review & Resource (URR). Contract & Vendor Management + Oversee contracts related ... This position provides direct supervision to ancillary service departments and behavioral health teams, ensuring that all services are integrated, high-quality, and… more
    Marrakech, Inc. (10/10/25)
    - Related Jobs

  • Licensed Clinical Social Worker - Eating Disorders…

    Sharp HealthCare (San Diego, CA)
    …response to therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan ... California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences; AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare)… more
    Sharp HealthCare (10/10/25)
    - Related Jobs

  • Transplant Care Nurse - Remote

    Highmark Health (Washington, DC)
    …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
    Highmark Health (10/10/25)
    - Related Jobs

  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
    HCA Healthcare (09/27/25)
    - Related Jobs

  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …planning, implementation and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as discharge ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...care experience required. Minimum of two (2) years of utilization review /case management experience and… more
    HCA Healthcare (10/13/25)
    - Related Jobs

  • Care Nurse Coordinator RN - Extended Acute…

    WellSpan Health (Mount Gretna, PA)
    …of alternative treatment settings to provide appropriate care. + Coordinate with Case Management as indicated. + Participates in the review of policy and ... + Engages assigned patients using Motivational Interviewing strategies in the active management of their health by encouraging participation in their care and… more
    WellSpan Health (10/15/25)
    - Related Jobs

  • Medical Director- Long Term Support and Service…

    Elevance Health (Marietta, OH)
    …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 ... healthcare services for target populations strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written,… more
    Elevance Health (09/26/25)
    - Related Jobs

  • Director Clinical Resources

    HCA Healthcare (St. Louis, MO)
    …product standardization efforts, and shape the future of clinical resource management . **Benefits** HealthTrust Performance Group, offers a total rewards package ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...Develop and direct standard process for monitoring of product utilization in key categories. + Develops and leads the… more
    HCA Healthcare (09/27/25)
    - Related Jobs

  • RN - Inpatient Case Manager (Daylight)

    Highmark Health (Jefferson Hills, PA)
    …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (10/09/25)
    - Related Jobs