• Utilization Management

    Katmai (Fort Carson, CO)
    …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
    Katmai (11/26/25)
    - Related Jobs
  • Utilization Management Reviewer,…

    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)
    - Related Jobs
  • Executive System Director of Utilization

    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
    UNC Health Care (10/29/25)
    - Related Jobs
  • 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 (11/07/25)
    - Related Jobs
  • Registered Nurse Utilization

    McLaren Health Care (Port Huron, MI)
    …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
    McLaren Health Care (11/12/25)
    - Related Jobs
  • Utilization Management

    McLaren Health Care (Flint, MI)
    …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN , to join in leading the organization forward. MHP ... service to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
    McLaren Health Care (12/18/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Carson City, NV)
    …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant... function. **Required Qualifications** -Must reside in PST zone. - RN with active and unrestricted state licensure in state… more
    CVS Health (12/21/25)
    - Related Jobs
  • Clinical Nurse III, Acute Inpatient…

    Alameda Health System (San Leandro, CA)
    Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
    Alameda Health System (12/16/25)
    - Related Jobs
  • Manager, Prior Authorization Utilization

    CVS Health (Baton Rouge, LA)
    …we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... professionals to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by… more
    CVS Health (12/21/25)
    - Related Jobs
  • Clinical Product Consultant - Utilization

    Waystar (Atlanta, GA)
    **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
    Waystar (11/21/25)
    - Related Jobs