• Utilization Management Nurse…

    CVS Health (Austin, TX)
    …+ Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
    CVS Health (12/23/25)
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  • Director, Utilization Management

    Fallon Health (Worcester, MA)
    …strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care, ... and staff across all product lines. **Responsibilities** ** Utilization Management :** + Oversees all administrative, operational and clinical functions related to… more
    Fallon Health (12/14/25)
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  • System VP Utilization Management

    CommonSpirit Health (Phoenix, AZ)
    **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials … more
    CommonSpirit Health (11/02/25)
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  • Executive System Director of Utilization

    UNC Health Care (Morrisville, NC)
    …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 complex academic health system and… more
    UNC Health Care (10/29/25)
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  • Utilization Management Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Utilization Management Registered…

    Katmai (Fort Carson, CO)
    **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
    Katmai (11/26/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (11/07/25)
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  • Utilization Management Nurse…

    CVS Health (Tallahassee, FL)
    …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, ... state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
    CVS Health (12/25/25)
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  • Utilization Management Nurse…

    CVS Health (Carson City, NV)
    …And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in ... year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and… more
    CVS Health (12/21/25)
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  • Utilization Management Registered…

    McLaren Health Care (Flint, MI)
    …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN, to join in leading the organization forward. MHP is a ... service to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
    McLaren Health Care (12/18/25)
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