• Utilization Management

    Elevance Health (Richmond, VA)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
    Elevance Health (09/10/25)
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  • Utilization Management

    Elevance Health (Cincinnati, OH)
    ** Utilization Management Representative II** **Schedule: Monday-Friday 8am-5pm Eastern Time** **Must be located near one of our Ohio PulsePoint offices in ... benefits and/or eligibility information. + May act as liaison between Medical Management and internal departments. + Responds to telephone and written inquiries from… more
    Elevance Health (08/19/25)
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  • Utilization Management Rep II

    Elevance Health (Walnut Creek, CA)
    ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... Friday, an 8-hour shift between 8 am - 8 pm EST. The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
    Elevance Health (09/11/25)
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  • Utilization Management Rep I

    Elevance Health (Richmond, VA)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
    Elevance Health (09/06/25)
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  • 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 ... of 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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  • Utilization Review Nurse Supervisor I

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE SUPERVISOR I ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working… more
    The County of Los Angeles (08/18/25)
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  • Board Certified Behavioral Analyst…

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …Oversee and direct work activities of unlicensed clinical staff involved in the utilization management process. + Communicate with ABA providers to gather ... policies. + Participate in the development and refinement of utilization management protocols and clinical review tools....behavioral health settings. _The Physical Demands described here are representative of those that must be met by an… more
    Blue Cross and Blue Shield of Louisiana (08/16/25)
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  • Manager - Contracts & Utilization

    Ochsner Health (Jefferson, LA)
    …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
    Ochsner Health (09/05/25)
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  • Sr Informatics Analyst (Pharmacy) - Fulltime…

    Henry Ford Health System (Troy, MI)
    …well as proponent of the proficiency, abilities and interests of representative department. Develop competency of various corporate databases and establish expertise ... requirements. Minimum 3 years experience in healthcare industry in reporting, data management or analysis. Two or more years experience with relational databases and… more
    Henry Ford Health System (09/10/25)
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  • Case Management Representative

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case ... management and social work department to facilitate efficient utilization of resources and discharge planning including referrals management , communication… more
    Houston Methodist (09/06/25)
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