• Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
    DirectEmployers Association (10/02/25)
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  • ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
    DirectEmployers Association (09/13/25)
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  • Conifer Revenue Cycle Solutions (Frisco, TX)
    …(2) years supervisory experience CERTIFICATES, LICENSES, REGISTRATIONS Preferred: Active state Registered Nurse license or Certified Coding Specialist credential ... development and implementation, and ongoing success of the Clinical Documentation Management Program. Educates members of the patient care team regarding… more
    Talent (09/15/25)
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  • Somatus (Utica, NY)
    …utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management ... telephonically as the need arises. **This is a fully remote role where New York licensure is required.** **The...Uses protocols and pathways in line with established disease management and care management programs and approved… more
    DirectEmployers Association (10/16/25)
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  • Somatus (Mclean, VA)
    …utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management ... telephonically as the need arises. **This is a fully remote role where compact licensure is strongly preferred.** **The...Uses protocols and pathways in line with established disease management and care management programs and approved… more
    DirectEmployers Association (10/07/25)
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  • BlueCross BlueShield of Tennessee (Memphis, TN)
    …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and...their residence if the state is participating in the Nurse Licensure Compact Law\. _Experience_ + 3 years \-… more
    DirectEmployers Association (10/15/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... Manager will collaborate closely with other members of the management team. This role is full-time on site in...role. Supervision Exercised: - Assumes responsibility for all nursing ( RN , LPN) and MA roles in the practice. 10… more
    DirectEmployers Association (09/26/25)
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  • Sentara Health (Virginia Beach, VA)
    …required- most in person patient and provider visits will be in Virginia Beach. RN Clinician responsible for case management services within the scope of ... and efficient utilization of health benefits; conducts gap in care management for quality programs. Assists with the implementation of member care plans by… more
    Appcast IO CPC (10/29/25)
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  • Parexel (Oklahoma City, OK)
    …Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
    DirectEmployers Association (10/10/25)
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  • Teleflex (Tampa, FL)
    …based Sales Representative, Anesthesia, is making connections with anesthesiologists, Certified Registered Nurse Anesthetist's (CRNA's), other members of the ... our world-class brands including: + LMA and Rusch airway management devices designed to help reduce the risk of...business plan. - Grow overall market share and increase utilization among existing accounts, while securing new users within… more
    DirectEmployers Association (10/15/25)
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