• Utilization Management

    Elevance Health (San Antonio, TX)
    ** Utilization Management Representative III** **Location:** This role requires associates to be in-office 5 days per week, at our San Antonio, TX location. ... The ** Utilization Management Representative III** is responsible for coordinating cases for precertification and prior authorization review. **How you will… more
    Elevance Health (06/23/25)
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  • Utilization Management

    Elevance Health (Latham, NY)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible… more
    Elevance Health (06/25/25)
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  • Utilization Review Nurse Supervisor I

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE SUPERVISOR I ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working… more
    The County of Los Angeles (05/22/25)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases… more
    UNC Health Care (06/24/25)
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  • Manager - Contracts & Utilization

    Ochsner Health (Jefferson, LA)
    …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
    Ochsner Health (06/13/25)
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  • Utilization Review Manager

    Phoenix House (Wainscott, NY)
    ** Utilization Review Manager** **Job Details** **Job Location** East Hampton Residential - Wainscott, NY **Position Type** Full Time **Education Level** Graduate ... **Job Category** Nonprofit - Social Services **Description** **SUMMARY** The Utilization Review (UR) Manager coordinates commercial, and Medicaid Managed Care… more
    Phoenix House (06/25/25)
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  • Manager - Utilization Review

    Ochsner Health (Lafayette, LA)
    …job manages the daily operations of all assigned divisions within the case management department in collaboration with the case management and social services ... each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations… more
    Ochsner Health (05/31/25)
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  • Supervisor, Utilization Review - Behavioral…

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …Healthcare providers, subscribers, claims, appeals, legal, networking, case management , customer service, and compliance. **QUALIFICATIONS** **Education** + ... managed care experience or three years BCBSLA + Care Management experience with progressive levels of responsibility and expertise...and Essential Functions** _The Physical Demands described here are representative of those that must be met by an… more
    Blue Cross and Blue Shield of Louisiana (06/20/25)
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  • Care Management Representative

    Saratoga Hospital (Saratoga Springs, NY)
    …the Collaborative Practice Groups under the guidance of the Director of Care Management . The Care Management Representative participates in a collaborative ... criteria to identify severity of illness & intensity of service for appropriate utilization management and 1st level criteria reviews. Documents required data in… more
    Saratoga Hospital (06/11/25)
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  • Care Management Representative

    Saratoga Hospital (Saratoga Springs, NY)
    …the Collaborative Practice Groups under the guidance of the Director of Care Management . The Care Management Representative participates in a collaborative ... identify severity of illness & intensity of service for appropriate utilization management and 1st level criteria reviews. Documents required data in Allscripts… more
    Saratoga Hospital (06/26/25)
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