- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, ... Reporting to the Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs is responsible for the day-to-day… more
- Christus Health (Schertz, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- University Health (San Antonio, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case Manager ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred....full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance… more
- Yale New Haven Health (New Haven, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required. more
- Yale New Haven Health (Bridgeport, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... Regarding Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information… more
- Yale New Haven Health (Shelton, CT)
- …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... According To Unit Policies And Procedures. Provides Supervision Of Non- Rn Personnel On The Assigned Unit. When Assuming The...Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS… more
- University Health (San Antonio, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is preferred. Case Manager ... Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is… more
- Baptist Memorial Health (Southaven, MS)
- …BMH - Desoto Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN Type: Clinical Work Type: Full Time Work Schedule: Days Location: ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Diploma or Associate Degree in Nursing Experience Preferred : RN with 3 years of clinical experience with Case… more
- Christus Health (Somerset, TX)
- …on for more details, and make sure to apply today. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of hospital ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Baptist Memorial Health (Memphis, TN)
- …this job overview, do not delay your application. Summary Manages resource utilization and communication to achieve the organizational goals. Has direct supervisory ... Experience Minimum : 5 years nursing with 1 year of management experience in related field. Leadership experience utilizing problem-solving methodologies. Licensure,… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
- 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
- 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 system, including a complex academic health system and… more
- 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
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 30, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- McLaren Health Care (Flint, MI)
- …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN , to join in leading the organization forward. MHP ... service to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
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