• Manager, Utilization Management

    Centene Corporation (New York, NY)
    …care, provider interactions, and facilitates operations within utilization management . + Manages prior authorization, concurrent review , and retrospective ... with applicable guidelines, policies, and procedures + Reviews and analyzes utilization management activities, operations, costs, and forecasted data to… more
    Centene Corporation (01/10/26)
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  • Supervisor, Utilization Management

    Centene Corporation (Madison, WI)
    … team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
    Centene Corporation (01/06/26)
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  • System VP Utilization Management

    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
    CommonSpirit Health (01/10/26)
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  • RN Director, Utilization Management…

    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
    Fallon Health (12/14/25)
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  • 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...Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate… more
    UNC Health Care (10/29/25)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …+ Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
    CVS Health (01/01/26)
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  • Utilization Management Registered…

    Katmai (Fort Carson, CO)
    **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... care standards for appropriate utilization of services. Perform utilization management / review for medical necessity for specialty referrals and… more
    Katmai (11/26/25)
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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 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
    Alameda Health System (11/07/25)
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  • Utilization Management RN

    CentraCare (St. Cloud, MN)
    …You will be responsible to conduct key components of the St Cloud Hospital Care Management and Utilization Review (UR) plans which includes activities to ... St. Cloud Hospital is seeking a dynamic and experienced Utilization Management RN to join our team....in any of the following functions: utilization review , performance improvement, quality assurance, risk management … more
    CentraCare (01/08/26)
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  • Utilization Management Manager

    State of Indiana (Indianapolis, IN)
    …The role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the ... Utilization Management Manager Date Posted: Jan... Utilization Management Manager Date Posted: Jan 6, 2026 Requisition...high quality care and services. You serve as the utilization management subject-matter expert in health care… more
    State of Indiana (01/05/26)
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