• Utilization Management…

    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)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management ... II + Six (6) months of experience in Utilization Management Per Diem RN III ... VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem Registered Nurse II/III - Utilization Management VCMC… more
    Ventura County (09/27/25)
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  • RN System Director Utilization…

    Tufts Medicine (Burlington, MA)
    …to the utilization of resources, coordination of care across the continuum and utilization review and management . The position develops and leads the ... 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 (10/01/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Columbus, OH)
    …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...position open to candidates nationwide.** **Candidates must have a Registered Nurse ( RN ) license for… more
    Centene Corporation (09/17/25)
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  • Senior Manager, Behavioral Health…

    Centene Corporation (Phoenix, AZ)
    … utilization management . + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines + Reviews ... Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
    Centene Corporation (09/14/25)
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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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  • Registered Nurse…

    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 ... in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical… more
    ERP International (09/17/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible ... reports to the Director of Utilization Management * Oversees clinical decision review for...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
    Commonwealth Care Alliance (10/02/25)
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  • Utilization Management…

    Crouse Hospital (Syracuse, NY)
    …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
    Crouse Hospital (09/25/25)
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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: Sep...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
    State of Indiana (09/26/25)
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