• RN System Director Utilization

    Tufts Medicine (Burlington, MA)
    … review and management . The position develops and leads the Utilization Management operations, strategy and implementation of the Utilization ... Science 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 (09/11/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location Ventura and Santa Paula, CA Job Type Per-Diem Job Number… more
    Ventura County (09/05/25)
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  • System VP Utilization Management

    CommonSpirit Health (Phoenix, AZ)
    **Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is charged with ... and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials … more
    CommonSpirit Health (09/05/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Columbus, OH)
    …IN STATE OF OHIO IDEAL CANDIDATE WILL HAVE PRIOR AUTHORIZAION OR UTILIZATION MANAGEMENT EXPERIENCE PEOPLE LEADER EXPERIENCE STRONGLY PREFERRED **Position ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
    Centene Corporation (08/23/25)
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  • Supervisor, Care Review (RN) Utilization

    Molina Healthcare (NM)
    …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… more
    Molina Healthcare (08/20/25)
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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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  • Director Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director, Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Registered Nurse - Utilization

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, Barksdale ... organization, professional organizations, and community health care facilities concerning Utilization Management . + Participates in in-services and continuing… more
    ERP International (06/18/25)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …And we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can ... the need of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
    CVS Health (09/10/25)
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  • Utilization Management Nurse Lead

    Humana (Lansing, MI)
    …part of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent ... best and most appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates and communicates with Providers,… more
    Humana (08/20/25)
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