• Manager , Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of … more
    Commonwealth Care Alliance (05/21/25)
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  • RN Utilization Management Clinical

    The Cigna Group (Sacramento, CA)
    …acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate ... requiring "expert" level technical support from others. Exercises judgment in the evaluation , selection, and adaptation of both standard and complex techniques and… more
    The Cigna Group (05/29/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    …quality. + Interface with Primary/Interdisciplinary Care Team including Care Coordinator, Care Manager , and others to consult on clinical decision making, ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
    Commonwealth Care Alliance (05/21/25)
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  • Product Utilization Mgr.

    BJC HealthCare (St. Louis, MO)
    …experience) **Additional Information About the Role** BJC HealthCare is seeking a Product Utilization Manager to assist with nursing and lab supplies. Ideal ... with physicians and clinicians within the HSO to engage in the identification, evaluation , pilot and execution processes for ensuring clinical efficacy of… more
    BJC HealthCare (06/12/25)
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  • Clinical Case Manager - Inpatient…

    Sharp HealthCare (San Diego, CA)
    …quality and cost effective care for patients throughout the continuum. The Clinical Case Manager facilitates and coordinates services with health care ... towards the achievement of quality and cost outcomes. The Clinical Case Manager is responsible for accurately...documentation of care management assessment, intervention, follow up and evaluation of care pertinent to utilization and… more
    Sharp HealthCare (06/07/25)
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  • Clinical Operations Manager

    CareOregon (Portland, OR)
    …Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Clinical Operations Manager Department Clinical Operations Exemption Status ... # 24994 Direct Reports Team Supervisors and Support Staff Manager Title Director, Clinical Operations Pay &...fulfilling established goals and objectives. + Develop and implement utilization programs and services to ensure the use of… more
    CareOregon (05/22/25)
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  • Quality Assurance Manager , Clinical

    CareOregon (Portland, OR)
    …Status Exempt Management Level Manager Direct Reports Registered Nurse - Clinical Quality Assurance, Registered Nurse - Utilization Management II Manager ... Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Quality Assurance Manager , Clinical Systems Requisition # 25017 Exemption… more
    CareOregon (06/11/25)
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  • Supervisor, Assistant Clinical

    Guthrie (Sayre, PA)
    …support staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within ... the Guthrie Robert Packer Hospital. May be assigned to special projects per Clinical Manager / Director consistent with strategic, fiscal, and operational… more
    Guthrie (06/11/25)
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  • RN Clinical Manager , Home Health

    CenterWell (Marietta, GA)
    **Become a part of our caring community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in their homes by ... providing health and personal services; supporting patients and their families. The Clinical Manager , Home Health Nursing works within specific guidelines and… more
    CenterWell (04/26/25)
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  • Clinical Resource Manager

    HCA Healthcare (Nashville, TN)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Resource Manager with HealthTrust Supply Chain you can be a ... in our organization. We are looking for an enthusiastic Clinical Resource Manager to help us reach...of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation more
    HCA Healthcare (06/21/25)
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  • RN Clinical Manager

    Erickson Living (Parkville, MD)
    …with annual bonus potential opportunity. Relocation assistance potential. Join our team as the Clinical Manager is an active member of the clinical ... delivery of safe and effective person-centered care in their assigned neighborhood. The Clinical Manager will also facilitate, precept, and mentor staff to grow… more
    Erickson Living (05/13/25)
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  • Clinical Case Manager -Oncology…

    Sharp HealthCare (San Diego, CA)
    …requirements for the position, and employer business practices. **What You Will Do** The Clinical Case Manager 's (CCM) role is to be a patient advocate providing ... that there are multiple options for patients and are provided excellent care. The Clinical Case Manager will be responsible for collecting data regarding patient… more
    Sharp HealthCare (04/18/25)
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  • Clinical Resources Manager

    HCA Healthcare (St. Louis, MO)
    …an RN** who wants to join an organization that invests in you as a ** Clinical Resources Manager ** ? At HealthTrust Performance Group, you come first. HCA ... and you have the opportunity to make a difference. We are looking for a dedicated Clinical Resources Manager like you to be a part of our team. **Job Summary… more
    HCA Healthcare (06/21/25)
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  • Clinical Manager - Integrated Care…

    FlexStaff (New York, NY)
    …reassessment, UAS-NY completion, comprehensive assessment, medication review, and post-hospital discharge evaluation . The Clinical Assessment Manager - Care ... **Req Number** 156311 FlexStaff is seeking a qualified Clinical Manager - Integrated Care Perm...Intake, Enrollment, and Care Delivery teams by documenting critical clinical enrollment, evaluation , and documentation of correct… more
    FlexStaff (04/18/25)
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  • Clinical Case Manager Behavioral…

    CVS Health (Little Rock, AR)
    …knowledgably participate with their provider in healthcare decision-making -Analyzes all utilization , self-report and clinical data available to consolidate ... to work standard business hours in CST or MST. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health… more
    CVS Health (06/21/25)
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  • Behavioral Health Clinical Case…

    CVS Health (Frankfort, KY)
    …participate with their provider in healthcare decision-making. + Analyzes all utilization , self-report and clinical data available to consolidate information ... with heart, each and every day. **Summary/Position Objectives:** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member… more
    CVS Health (06/18/25)
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  • Manager Clinical Education

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Manager Clinical Education position is responsible for collaboratively working with the Center for Nursing Research to support the ... HM-generated nursing knowledge to both nursing and general healthcare communities. The Manager Clinical Education position serves to implement quality evidence… more
    Houston Methodist (03/29/25)
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  • Clinical Assessment Manager - Care…

    CenterLight Health System (Flushing, NY)
    …reassessment, UAS-NY completion, comprehensive assessment, medication review, and post-hospital discharge evaluation . The Clinical Assessment Manager - Care ... as Intake workflows related to accurate and timely completion of UAS assessments. The Clinical Assessment Manager - Care Delivery serves as a valuable resource… more
    CenterLight Health System (06/13/25)
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  • Clinical Manager (RN) - Renal…

    RWJBarnabas Health (New Brunswick, NJ)
    Clinical Manager (RN) - Renal TransplantReq #:47591 Category:Leadership Status:Full-Time Shift:Day Facility:RWJ New Brunswick Department:Organ Transplants ... Wood Johnson Place, New Brunswick, NJ 08901 Job Title: Clinical Manager Location: RWJ New Brunswick Department:...Transplant will play a crucial role in overseeing all clinical and administrative operations related to patient evaluation more
    RWJBarnabas Health (04/12/25)
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  • Clinical Case Manager Behavioral…

    CVS Health (Antioch, IL)
    …not limited to: hospital setting, outpatient clinic, PCP office, or member's residence. The Clinical Care Manager - BH is responsible for care coordination and ... members, up to age 20, who have experienced a behavioral health crisis event. The Clinical Case Manager - BH: Utilizes advanced clinical judgment and… more
    CVS Health (06/18/25)
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