- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Sep 26, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review,… more
- 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 ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost… more
- Prime Healthcare (Chino, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226811/case- manager -%28rn%29 utilization - ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Actalent (Santa Barbara, CA)
- …unit, such as Mental/Behavioral Health services. Skills: Care plans, Case Manager , Pediatrics, Utilization Management , Clinical Reviews Experience ... Remote Utilization Management RN Leading healthcare facility that aims to improve the health and wellness of those in need is now looking for a REMOTE Health… more
- Centene Corporation (Phoenix, AZ)
- …ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with… more
- Molina Healthcare (WA)
- …unrestricted State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified ... licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of training… more
- Molina Healthcare (GA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... or more of the following activities: care review, care management , utilization management (prior authorizations,...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more
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