• Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
    Alameda Health System (08/08/25)
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  • Director Utilization

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical ... with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships,...Essential Qualifications + Active and unrestricted license as a Registered Nurse ( RN ). + Bachelor's… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... operational leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a… more
    UNC Health Care (07/27/25)
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  • Registered Nurse

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a ** Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical ... and other health team members. Submits all concerns through Utilization Management Director ; be able...Management is required. Full time employment as a registered nurse within the last 36 months… more
    ERP International (06/18/25)
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  • Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    011200 CCA-Central Clin Ops Leadership **Position Summary:** Reporting to the Sr. Medical Director of Utilization Management (UM) and Policy, the Medical ... to the population serviced by CCA. The Medical Policy Director is an independent contributor who works in partnership...have):** + 10 years of experience in medical policy, utilization management , clinical program leadership within a… more
    Commonwealth Care Alliance (05/31/25)
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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (08/02/25)
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  • Utilization Review Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
    Emory Healthcare/Emory University (08/08/25)
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  • Registered Nurse RN Associate…

    Banner Health (Susanville, CA)
    …area. (https://youtu.be/sTPoc9EbJ\_Y) Banner Lassen Medical Center is looking for a full-time Registered Nurse Associate Director to lead the emergency ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...improvement initiatives of the department in conjunction with the director . Seeks and utilizes input from staff and oversees… more
    Banner Health (07/18/25)
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  • Registered Nurse Utilization

    LifePoint Health (Louisburg, NC)
    Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... select a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator* **Location:**… more
    LifePoint Health (08/09/25)
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  • Inpatient Registered Nurse

    St. Luke's University Health Network (Coaldale, PA)
    …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director . + Facilitates communication among ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
    St. Luke's University Health Network (07/17/25)
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