• RN Utilization Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
    UNC Health Care (12/24/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...in utilization management and appeal/denial management . + Holds a strong working knowledge more
    Beth Israel Lahey Health (12/14/25)
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  • Manager , Prior Authorization…

    CVS Health (Baton Rouge, LA)
    …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... setting, management of direct reports preferred + Strong knowledge of utilization management principles, regulatory requirements, and payer requirements.… more
    CVS Health (12/21/25)
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  • Care Manager RN - Utilization

    Highmark Health (Harrisburg, PA)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
    Highmark Health (12/18/25)
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  • Manager of Utilization

    Elevance Health (Washington, DC)
    …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
    Elevance Health (11/25/25)
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  • Utilization Management

    UCLA Health (Los Angeles, CA)
    …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager more
    UCLA Health (12/30/25)
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  • Registered Nurse Case Manager (RN)…

    Hartford HealthCare (Willimantic, CT)
    …Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other ... moment.* **Job:** **Nursing* **Organization:** **Windham Hospital* **Title:** *Registered Nurse Case Manager (RN) - Utilization Management * **Location:**… more
    Hartford HealthCare (12/24/25)
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  • Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...to deliver financial results for areas of accountability * Knowledge of or ability to learn financial management more
    Minnesota Visiting Nurse Agency (12/06/25)
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  • RN - Case Manager - BSN -…

    John Muir Health (Walnut Creek, CA)
    …the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** + ... manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager ...Support - American Heart AssociationRequired + ACM Accredited Case Manager - ACMA American Case Management Association… more
    John Muir Health (12/27/25)
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  • RN, Hospital Case Manager

    Baystate Health (Springfield, MA)
    …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... experience strongly preferred **Skills and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and… more
    Baystate Health (12/19/25)
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