• UM LVN

    Dignity Health (Bakersfield, CA)
    …to patient information, PHI and HIPAA regulations. **Preferred Qualifications:** - Prior Utilization Management (UM) experience strongly preferred. - Bachelor's ... as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse… more
    Dignity Health (07/13/25)
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  • Clinical Authorization Specialist

    Dana-Farber Cancer Institute (Brookline, MA)
    …+ 1 year of clinical and/or related experience required. Case Management, Utilization Review and/or Prior Authorization experience is preferred. + ... environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient… more
    Dana-Farber Cancer Institute (08/08/25)
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  • Medical Director-Medicaid (ABH-LA)

    CVS Health (Baton Rouge, LA)
    …review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization and precertification as well ... - Family Medicine, Emergency Medicine, Internal Medicine-Pediatrics Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or experience… more
    CVS Health (08/08/25)
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  • Medical Director - West Virginia Medicaid

    CVS Health (Charleston, WV)
    …concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization and pre certification as ... - Family Medicine, Emergency Medicine, Internal Medicine-Pediatrics Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or experience… more
    CVS Health (08/08/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location...Must possess a valid Basic Life Support (BLS/CPR) Certificate PRIOR to the first day of employment. *These competency… more
    Ventura County (08/10/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: *Manages ... the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising staff performing … more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Utilization Management Nurse

    Actalent (Sunrise, FL)
    Actalent is hiring a Utilization Management Nurse! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to ... perform reviews of service authorization requests, ensuring the utilization of appropriate services. The UMN assists in complex cases, develops internal processes,… more
    Actalent (07/29/25)
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  • Utilization Management Nurse

    Adecco US, Inc. (Minneapolis, MN)
    Adecco Healthcare & Life Sciences is hiring ** Utilization Management Nurses** ! This role is work from home and remote but we are requiring Nurses to live in Texas. ... $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse** : . Responsible for reviewing proposed.... Relevant experience in UM process activities such as prior authorization or medical claims review . Resides in… more
    Adecco US, Inc. (07/15/25)
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  • Utilization Review Nurse Supervisor II

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR ... service are met and is subject to closure without prior notice. ABOUT LOS ANGELES COUNTY DEPARTMENT OF HEALTH...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,… more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review, the Utilization Review Medical Director will be responsible ... for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping our organization provide high… more
    Commonwealth Care Alliance (06/27/25)
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