• UTMB Health (Webster, TX)
    …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... specialty medications Participates in the operations of medication therapy management Initiates medication reconciliation Assists with screening, documentation, and… more
    job goal (12/12/25)
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  • Utilization Management

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
    CareFirst (11/22/25)
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  • Behavioral Health Utilization

    AmeriHealth Caritas (LA)
    …Under the direction of the Supervisor , the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity ... and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care organization desired + Proficiency… more
    AmeriHealth Caritas (11/19/25)
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  • Utilization Review Nurse Supervisor

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print... Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually Location Los… more
    The County of Los Angeles (10/06/25)
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  • Utilization Management Reviewer, RN…

    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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  • Registered Nurse (RN) Utilization

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...requirements are met + Additional duties as requested by supervisor + Maintains knowledge of CMS, State and NCQA… more
    Commonwealth Care Alliance (10/02/25)
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  • Utilization Management Nurse (RN)…

    Saint Francis Health System (OK)
    …placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma 73105… more
    Saint Francis Health System (12/13/25)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shifts Covenant Health Overview: Covenant Health is the region's ... to be named a Forbes "Best Employer" seven times. Position Summary: The RN Utilization Management I will perform utilization management functions… more
    Covenant Health Inc. (12/18/25)
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  • Staff Utilization Coordinator

    University of Utah Health (Salt Lake City, UT)
    … to reassign staff based on census and workload, adhering to the Nurse Utilization Policy. + Assist Hospital Supervisor and Nursing Leadership in identifying ... are integral to our mission. EO/AA_ + The Staff Utilization Coordinator is responsible for providing healthcare operational support...care needs. + The role also involves proactive daily management to secure staff for open shifts to ensure… more
    University of Utah Health (12/02/25)
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  • Travel Nurse RN Utilization

    Ascension Health (Baltimore, MD)
    …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for resources and removal of barriers. + Maintain ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan.… more
    Ascension Health (10/17/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
    Helio Health Inc. (12/02/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials.… more
    BayCare Health System (10/10/25)
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  • Manager, Inpatient Pharmacist - Pharmacy…

    University of Rochester (Rochester, NY)
    …conduct the business of the functional unit under their supervision and management . Their supervisor should be aware of all ongoing interdepartmental ... defined by NYS Laws and Regulations. The Pharmacy Medication Utilization and Inventory Compliance Manager has direct supervision and...frequency of reporting will be agreed upon with their Supervisor . + Performs budget management and planning… more
    University of Rochester (11/12/25)
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  • Social Worker - Emergency Dept (High…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Job Title:** **Social Worker - Emergency Dept (High Utilization )** **_Social Work Services at the Mount Sinai Hospital_** The Mount Sinai ... in coordinating resources within the hospital and community networks for effective management of patient care. + Spanish speaking _preferred._ + Internal candidates:… more
    Mount Sinai Health System (12/10/25)
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  • RN or LPN - Utilization Manager

    Northeast Alabama Regional Medical Center (Anniston, AL)
    Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care of patients to facilitate achievement of positive ... care as appropriate. Participates in performance improvement initiatives related to the management of patient care. Works with physicians to ensure accurate and… more
    Northeast Alabama Regional Medical Center (11/15/25)
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  • Case Management Supervisor - Full…

    Mohawk Valley Health System (Utica, NY)
    Case Management Supervisor - Full Time - Days Department: CASE MGMT Job Summary The Case Management Supervisor is responsible for the oversight of the ... case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision and mentoring of the case … more
    Mohawk Valley Health System (11/21/25)
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  • RN Supervisor Case Management - Full…

    Mohawk Valley Health System (Utica, NY)
    RN Supervisor Case Management - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Supervisor Case Management - SNH is responsible ... for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision and… more
    Mohawk Valley Health System (10/07/25)
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  • Data Management and Analytics Unit…

    California Energy Commission (Sacramento, CA)
    Data Management and Analytics Unit Supervisor PROGRAM AND PROJECT SUPERVISOR , PUBLIC UTILITIES COMMISSION $12,562.00 - $15,724.00 per Month New to State ... Position Details Job Code #: JC-501077 Position #(s): ###-962 Working Title: Data Management and Analytics Unit Supervisor Classification: PROGRAM AND PROJECT … more
    California Energy Commission (12/16/25)
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  • Senior Supervisor of Building…

    Wawa, Inc. (IA)
    …Technology **Location:** Corporate **Department:** Facilities **Job Summary** **:** The Senior Supervisor of Building Management Systems is responsible for the ... Automation System (BAS) and to support the daily operations of the Facilities Management System. The position is responsible to manage relationships with the Contact… more
    Wawa, Inc. (11/06/25)
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  • Supervisor Care Management RN…

    Pacific Medical Centers (Renton, WA)
    Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health ... and USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Providence caregivers are not… more
    Pacific Medical Centers (10/11/25)
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