• Manager , Healthcare Services

    Molina Healthcare (GA)
    …of Georgia. JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: ... and supports (LTSS), and/or member assessment. * Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal… more
    Molina Healthcare (09/19/25)
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  • Director, Healthcare Services

    Molina Healthcare (GA)
    …Licensure. JOB DESCRIPTION Job Summary Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: ... one or more of the following key health care services functions: care management, utilization management, care...clinical services . * Collaborates with and keeps healthcare services senior leadership informed of operational… more
    Molina Healthcare (09/19/25)
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  • Nurse Supervisor, Healthcare

    Molina Healthcare (Los Angeles, CA)
    …preferred** **JOB DESCRIPTION** Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following ... functions: care management, utilization management, behavioral health, care transitions, long-term ...of protocols and guidelines. * Collaborates with and keeps healthcare services leadership apprised of operational issues,… more
    Molina Healthcare (09/25/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization ... acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare . Key services include general medical and surgical inpatient… more
    Prime Healthcare (08/08/25)
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  • Case Manager (RN) - Utilization

    Prime Healthcare (Chino, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226811/case- manager -%28rn%29 utilization ... community's health care needs with top-rated emergency care as well as senior services , orthopedics, surgical services and more. Learn more atwww.cvmc.com. Join… more
    Prime Healthcare (09/30/25)
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  • Associate Manager , Clinical Health…

    CVS Health (UT)
    …promote high-quality healthcare for members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This ... team maintains compliance and privacy practices. + Oversees the implementation of utilization management services for assigned area + Implements clinical… more
    CVS Health (10/02/25)
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  • Case Manager - Utilization

    Prime Healthcare (Montclair, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization ... core values of quality, compassion, and community! Why Prime Healthcare ? (https://montclair-hospital.org/careers/why- healthcare -prime/) Montclair Hospital Medical Center is… more
    Prime Healthcare (09/30/25)
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  • Utilization Manager Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards ... and post- service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions,… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... * National certification of any of the following: CPHM (Certified Professional in Healthcare Management), CCM (Certified Case Manager ), ACM (Accredited Case … more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees,...acute care hospitals, three nursing homes, a home health service , hospice and a network of physician practices across… more
    Catholic Health Services (07/24/25)
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