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Keywords: Medical Director, Utilization Management, Location: USA

Page: 3

Market Director - Utilization Management

Details Department: Utilization Management Schedule: Full-time, Day shift. Monday - Friday Location: Remote (4... Ascension Utilization Management program across the Ministry Markets assigned and directs tactics to support strategic goals...

Company: Ascension
Location: USA
Posted Date: 31 Oct 2025

Director, Utilization Management Support Operations

perspective on workplace flexibility. Position Purpose: Directs the utilization management team to ensure the appropriate... specific to the daily operations of Utilization Management including timeliness, quality and performance outcomes, provider...

Company: Centene
Location: USA
Posted Date: 31 Oct 2025
Salary: $131100 - 242500 per year

RN System Director Utilization Management - Primarily Remote

continuum and utilization review and management. The position develops and leads the Utilization Management operations, strategy... and implementation of the Utilization Management model and tactics. The position is responsible for assuring success in financial...

Company: Tufts Medicine
Location: Burlington, MA
Posted Date: 26 Aug 2025

Utilization and Clinical Review - Medical Director - Orthopedic Surgery - Remote

and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects... Medical Director also provides/assists in the direction and oversight in the development and implementation of policies...

Company: CPS Solutions
Location: Minneapolis, MN
Posted Date: 11 Oct 2025

Coordinator - PI - PRMC Utilization Management

, and community! Pampa Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons... Medical Center is a 25-bed critical-access hospital serving our communities with a full range of surgical and medical services...

Posted Date: 25 Oct 2025

Supervisor of Utilization Management

Supervisor of Utilization Management - Concurrent Review VillageCareMAX 112 Charles Street, New York, NY 10014... **MUST LIVE IN NJ/NY/CT** VillageCare is looking for a motivated RN for our Supervisor of Utilization Management - Concurrent...

Company: VillageCare
Location: New York City, NY
Posted Date: 05 Nov 2025
Salary: $110000 - 125000 per year

Utilization Management Nurse Consultant

. And we do it all with heart, each and every day. Position Summary This is a fulltime remote Utilization Management opportunity... that utilizes MCG rules and applies medical necessity guidelines to service requests. Works closely with leadership and Medical...

Company: CVS Health
Location: New York
Posted Date: 04 Nov 2025

Senior Utilization Management Assistant PD Day

is Per Diem and will work 8-hour, Day shifts (REMOTE). Under the supervision of Regional Director of Care Management, the... Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care...

Posted Date: 02 Nov 2025

Utilization Management RN

as applicable. Makes referrals to Case Management as needed. Sends thorough reviews to Medical Director as appropriate... of the use of medical services procedures and facilities. Responsible for clinical review of acute care services based...

Company: MedStar Health
Location: Washington DC
Posted Date: 31 Oct 2025
Salary: $87318 per year

Registered Nurse-Utilization Management Nurse

that 2-10p shift will be required. Under the general supervision of the Sr. Director, Case Management the Utilization... Utilization Management Nurse assesses the patient's plan of care and progress of the patient throughout an acute care admission...

Posted Date: 31 Oct 2025
Salary: $89840 - 114550 per year

RN Utilization Management Nurse - MST or EST Preferred - Remote

Collaborate with UnitedHealthcare Medical Directors on performing utilization management Participation in discussions with the... Clinical Services team to improve the progression of care to the most appropriate level Consult with the Medical Director...

Location: Greenville, SC
Posted Date: 30 Oct 2025
Salary: $58800 - 105000 per year

RN Utilization Management Nurse (NICU / Peds) – California

Anticipated End Date: 2025-11-15 Position Title: RN Utilization Management Nurse (NICU / Peds) – California... Job Description: RN Utilization Management Nurse (NICU / Peds) – California (JR169694) Virtual: This role enables associates to work...

Company: Elevance Health
Location: Woodland Hills, CA
Posted Date: 30 Oct 2025

LPN-Utilization Mgmt Reviewer - Case Management - Full Time

Job Category: Admin Support/Clerical Job Description: Summary The LPN Utilization Management (UM) Reviewer... Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization...

Company: Guthrie
Location: Cortland, NY
Posted Date: 29 Oct 2025
Salary: $20.38 - 31.81 per hour

Utilization Management RN - Behavioral Health (CA Licensed)

and appropriateness of services using clinical review criteria Collaborate with Medical Director(s) for appropriate referrals, complex..., Commercial, etc.) 2+ years of utilization management experience Strong knowledge of utilization management processes...

Location: California
Posted Date: 25 Oct 2025
Salary: $70000 - 100000 per year

Registered Nurse (RN) - Utilization Management, PRN, Days

care nursing experience. One (1) year acute case management or utilization management experience preferred. Utilization... Utilization Management Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the...

Posted Date: 24 Oct 2025

Physician Advisor, Utilization Management

position involving clinical care, quality management, utilization and case management, or medical staff governance... to obtain necessary approvals of new strategies for utilization management. Knowledge of current medical literature, research...

Location: USA
Posted Date: 24 Oct 2025

Behavioral Health Utilization Management Reviewer

Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer... to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management...

Location: USA
Posted Date: 23 Oct 2025

Behavioral Health Utilization Management Reviewer

Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer... to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management...

Location: USA
Posted Date: 22 Oct 2025

Sr. Manager, Behavioral Health Utilization Management

will report to the Director, Behavioral Health Utilization Management. In this role you will be responsible for managing..., including staffing forecasts Represent BH Utilization Management as the Subject Matter Expert during in internal and external...

Posted Date: 18 Oct 2025

Utilization Management Clinical Support Specialist: Hoag Clinic Utilization Management

Job Category: Administrative Support Job Description: Primary Duties and Responsibilities The Utilization Management... and/or UM Medical Director, verifying request for information, compliance with HIPAA and privacy standards, and accurately enters...

Company: Hoag
Location: USA
Posted Date: 16 Oct 2025