• Utilization Management Coordinator-…

    Houston Behavioral Healthcare Hospital (Houston, TX)
    …Behavioral Healthcare Hospital (HBHH) currently has an opening for Part-time Utilization Management Coordinator. The Utilization Management Coordinator will ... report to the Director of Utilization Review and will be responsible to provide quality...1 year experience in a medical related field and/or prior authorization experience preferred. Experience in a Psychiatric setting.… more
    Houston Behavioral Healthcare Hospital (09/12/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Topeka, KS)
    …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
    CVS Health (09/10/25)
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  • Director of Case Management - Utilization

    Prime Healthcare (Inglewood, CA)
    …and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive ... case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Additionally,… more
    Prime Healthcare (08/26/25)
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  • Utilization Management Rep II

    Elevance Health (Walnut Creek, CA)
    ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... Friday, an 8-hour shift between 8 am - 8 pm EST. The ** Utilization Management Representative II** is responsible for managing incoming calls, including triage,… more
    Elevance Health (09/11/25)
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  • Utilization Management Rep I

    Elevance Health (Richmond, VA)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
    Elevance Health (09/06/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all ... determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a professional and… more
    Centene Corporation (08/02/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services ... requiring prior authorization. This includes approval determinations and appropriate exceptions,...a Registered Nurse. + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims… more
    CDPHP (09/06/25)
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  • Machine Learning Engineer, Sponsored Product…

    Amazon (Palo Alto, CA)
    …the Role This position will be part of the Sponsored Product Demand Utilization team within the Amazon Advertising organization. You will work hands-on with ... systems. This position is ideal for an engineer with prior MLOps or MLInfra experience looking to have exposure...while delivering impact across teams in the SP Demand Utilization Org. You will have experience working with multiple… more
    Amazon (08/09/25)
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  • Registered Nurse ( Utilization Quality…

    Veterans Affairs, Veterans Health Administration (Leeds, MA)
    …of healthcare services. Collaborate with multidisciplinary teams to ensure proper utilization of healthcare resources. Develop and implement UM policies and ... subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested...registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement… more
    Veterans Affairs, Veterans Health Administration (09/10/25)
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  • Pre-Authorization Specialist - Utilization

    CaroMont Health (Gastonia, NC)
    Job Summary: The Pre-Authorization Specialist is a member of the Utilization Review Department who is responsible for verifying eligibility, obtaining insurance ... benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.… more
    CaroMont Health (09/13/25)
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