- Mount Sinai Health System (New York, NY)
- …**Program Director (Licensed)** is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and value-based care populations. ... **Experience Requirements** + 7 plus years of experience in care management , utilization management , population health, or value-based care. + Demonstrated… more
- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials … more
- 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
- Fallon Health (Worcester, MA)
- …strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care, ... and staff across all product lines. **Responsibilities** ** Utilization Management :** + Oversees all administrative, operational and clinical functions related to… more
- UNC Health Care (Morrisville, NC)
- …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 complex academic health system and… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
- 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
- CentraCare (St. Cloud, MN)
- …Nursing Job Schedule: Full time St. Cloud Hospital is seeking a dynamic and experienced Utilization Management RN to join our team. In this pivotal role, the ... Utilization Management Nurse will play an integral part in determining the optimal level of care for each patient admission while ensuring adherence to regulatory… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Jan 6, 2026 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review, clinically… more
- Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible and accountable for all elements of the nursing process when providing consultation ... to the next care levels along the care continuum. Responsibilities The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that… more