• Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
    Alameda Health System (11/07/25)
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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 (10/29/25)
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  • Senior Director of Health Services…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan, Minnesota Career Area: Health Services ... difference, join us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for the design, strategic… more
    Blue Cross and Blue Shield of Minnesota (12/24/25)
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  • RN Director , Utilization

    Fallon Health (Worcester, MA)
    … to identify and prioritize the cost of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care,… more
    Fallon Health (12/14/25)
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  • Program Director ( Utilization

    Mount Sinai Health System (New York, NY)
    Director (Licensed)** is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and value-based care populations. This ... **Experience Requirements** + 7 plus years of experience in care management , utilization management , population health, or value-based care. + Demonstrated… more
    Mount Sinai Health System (01/10/26)
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  • Director , Utilization

    Centene Corporation (Richmond, VA)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure the appropriate application of ... manages Utilization Operations specific to the daily operations of Utilization Management including timeliness, quality and performance outcomes, provider… more
    Centene Corporation (01/06/26)
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  • Director Utilization

    Healthfirst (NY)
    …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
    Healthfirst (12/04/25)
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  • Associate Medical Director

    Insight Global (New York, NY)
    …turn-around times for clinical reviews. * Collaborate with other departments on Utilization Management Operations. * Lead key projects and drive initiatives ... leading and overseeing a team of physicians ensuring efficient management and adherence to quality standards. Primary Duties and...3+ years of clinical practice * 2+ years of utilization review experience in a managed care plan (health… more
    Insight Global (01/09/26)
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  • Utilization Management Medical…

    Elevance Health (Indianapolis, IN)
    ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... Internal Medicine, and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license or the ability… more
    Elevance Health (01/08/26)
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  • Director Utilization Mgmt…

    Wellpath (Cleveland, OH)
    …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
    Wellpath (12/20/25)
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