• Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization more
    Prime Healthcare (10/18/25)
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  • RN System Director Utilization

    Tufts Medicine (Burlington, MA)
    …1. Bachelor of Science in Nursing (BSN). 2. RN Licensure. 3. Current certification in case / utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/ ... management . The position develops and leads the Utilization Management operations, strategy and implementation of...Case Management experience in an acute-care hospital… more
    Tufts Medicine (10/26/25)
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  • Medical Director Utilization

    AmeriHealth Caritas (Philadelphia, PA)
    **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization ... practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical...+ Assists Care Managers in assessing members' needs for case management services and attends meetings and… more
    AmeriHealth Caritas (10/17/25)
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  • Director , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …responsibility for managing the effective utilization of healthcare services, case / disease management , program development/ management /evaluation and ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
    Commonwealth Care Alliance (10/02/25)
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  • LVN Utilization Review - SRS Inpatient…

    Sharp HealthCare (San Diego, CA)
    …Years experience as an LVN in a hospital or clinical setting. + 2 Years utilization / Case Management experience, preferably in a Managed Care setting. + ... hiring teams. **What You Will Do** To provide comprehensive utilization management and coordination of care for...Experience as a case manager or discharge planner interacting with managed care… more
    Sharp HealthCare (10/12/25)
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  • Utilization Review Case

    UTMB Health (Webster, TX)
    …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
    UTMB Health (10/22/25)
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  • Director Utilization

    Texas Health Resources (Arlington, TX)
    Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
    Texas Health Resources (10/16/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    …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 (08/08/25)
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  • Director , Healthcare Services;…

    Molina Healthcare (GA)
    …of healthcare services professionals in some or all of the following functions: utilization management , care management , behavioral health and other ... one or more of the following key health care services functions: care management , utilization management , care transitions, long-term supports and services… more
    Molina Healthcare (09/19/25)
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  • Senior Director Case

    Houston Methodist (Houston, TX)
    …for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the ... At Houston Methodist, the Sr Director Case Management position... initiatives. + Provides strategic vision and execution for case management and utilization review… more
    Houston Methodist (10/16/25)
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