• Manager , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of… more
    Commonwealth Care Alliance (10/02/25)
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  • RN, Manager , Utilization

    Humana (Augusta, ME)
    **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
    Humana (09/28/25)
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  • Utilization Management

    State of Indiana (Indianapolis, IN)
    Utilization Management Manager Date Posted: Sep 26, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review,… more
    State of Indiana (09/26/25)
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  • Utilization Management

    Elevance Health (Washington, DC)
    …office 4 days each week. The office is located at 609 H. Street NE.** The ** Utilization Management ** ** Manager ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
    Elevance Health (08/29/25)
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  • Associate Manager , Clinical Health…

    CVS Health (UT)
    …**Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and ... 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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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
    Beth Israel Lahey Health (07/29/25)
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  • Utilization Manager Registered Nurse…

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
    Commonwealth Care Alliance (10/02/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
    Prime Healthcare (08/08/25)
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  • Case Manager - Utilization

    Prime Healthcare (Montclair, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost… more
    Prime Healthcare (09/30/25)
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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 - ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
    Prime Healthcare (09/30/25)
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