• Utilization Management

    Excellus BlueCross BlueShield (Rochester, NY)
    …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management ... II + Six (6) months of experience in Utilization Management Per Diem RN III ... VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem Registered Nurse II/III - Utilization Management VCMC… more
    Ventura County (09/27/25)
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  • RN System Director Utilization

    Tufts Medicine (Burlington, MA)
    …to the utilization of resources, coordination of care across the continuum and utilization review and management . The position develops and leads the ... in Nursing (BSN). 2.Massachusetts RN Licensure. 3. Current certification in case/ utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/Case… more
    Tufts Medicine (10/01/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Columbus, OH)
    …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...position open to candidates nationwide.** **Candidates must have a Registered Nurse ( RN ) license for… more
    Centene Corporation (09/17/25)
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  • Manager, Utilization Management

    Centene Corporation (Oklahoma City, OK)
    …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... care, provider interactions, and facilitates operations within utilization management . + Manages prior authorization, concurrent review , and retrospective… more
    Centene Corporation (10/08/25)
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  • Senior Manager, Behavioral Health…

    Centene Corporation (Phoenix, AZ)
    utilization management . + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines + Reviews ... Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
    Centene Corporation (09/14/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (08/08/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible ... reports to the Director of Utilization Management * Oversees clinical decision review for...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
    Commonwealth Care Alliance (10/02/25)
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  • Utilization Management

    Crouse Hospital (Syracuse, NY)
    …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
    Crouse Hospital (09/25/25)
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  • Utilization Management Manager

    State of Indiana (Indianapolis, IN)
    …The role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the ... Utilization Management Manager Date Posted: Sep...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
    State of Indiana (09/26/25)
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