• Luke Staffing (Yigo, GU)
    …+ **Licensure:** Current, full, active, and unrestricted license to practice as a Practical OR Registered Nurse in any one of the 50 States, the District of ... ** NURSE - REFERRAL MANAGEMENT** **SITE OF SERVICE:** +...other health team members. + Submits all concerns through Utilization Management Director ; be able to identify,… more
    DirectEmployers Association (11/13/25)
    - Save Job - Related Jobs - Block Source
  • Alameda Health System (Oakland, CA)
    …or related fields. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia RequiredExperience:Seven years of ... Director , Service Line Administration + Oakland, CA +...development, revenue generation, and expenditure control to optimize the utilization of resource at greatest value. + Represents the… more
    DirectEmployers Association (10/16/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider ... network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance operational engagement, member access, provider… more
    DirectEmployers Association (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Boston, MA)
    021350 Clin Alli-Care Delivery Administration Position Summary: The Director , Behavioral Health Care Delivery is responsible for the strategy and leadership of CCA's ... in all CCA Care Delivery programs with BH components.The Director will collaborate closely with the Care Delivery Leadership...populations - Knowledge of BH & SUD care delivery systems and levels of care across the state. -… more
    DirectEmployers Association (10/21/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Springfield, MA)
    …Abilities & Language (nice to have):** + Familiarity with care management and utilization management systems and workflows for populations with complex medical, ... performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and Provider Engagement. The Provider Engagement team… more
    DirectEmployers Association (10/17/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Boston, MA)
    …manager, and performance partner - using data, provider feedback, and system collaboration to enhance provider engagement, improve outcomes, and strengthen ... quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - No,… more
    DirectEmployers Association (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Boston, MA)
    …compliance. The Senior Business Analyst, Clinical Operations reports to the Director , Clinical Operations Support. This role will provide significant BA support ... **Reports and Tools** + Engages with stakeholders to understand current processes/ systems and pain points as well as elicit detailed business needs… more
    DirectEmployers Association (08/28/25)
    - Save Job - Related Jobs - Block Source
  • Director , Utilization Management

    Alameda Health System (Oakland, CA)
    …off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational ... Director , Utilization Management + Oakland, CA...background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
    Alameda Health System (11/07/25)
    - Save Job - Related Jobs - Block Source
  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …health and well-being of 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… more
    UNC Health Care (10/29/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Clinician (Santa Rosa)

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …LVN/LPT $31.50-37.50 Per Hour RN /LCSW/LMFT/LPCC $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... the greater Santa Rosa and Northern California mental health system of care. Conveniently located in the North Bay,...substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE:… more
    Sacramento Behavioral Healthcare Hospital (10/24/25)
    - Save Job - Related Jobs - Block Source
  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered ... As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center...part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case… more
    Prime Healthcare (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Director of Case Management and Logistics

    Bassett Healthcare (Cooperstown, NY)
    …At least 5 years of experience in Case Management, discharge planning, and/or Utilization Management Licensure/Certifications: + Registered Nurse or LMSW or ... resources for the department. Oversees and works with the Director of Utilization Management to support and...issues to SVP, Chief Nursing Executive.* Development of Bassett Network/ System Thinking - A leader who thinks globally and… more
    Bassett Healthcare (10/29/25)
    - Save Job - Related Jobs - Block Source
  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... for all hospital-based Case Management Directors and the Central Utilization Review Director across the system...approach in the optimization of safe outcomes and information systems by monitoring and improving the system -wide… more
    Houston Methodist (10/16/25)
    - Save Job - Related Jobs - Block Source
  • Asst Director Patient Care…

    RWJBarnabas Health (Newark, NJ)
    Asst Director Patient Care Registered Nurse ( RN ) Full Time Days CTICUReq #:0000204650 Category:Nursing Manager Status:Full-Time Shift:Day Facility:Newark ... Location: 201 LYONS AVENUE, NEWARK, NJ 07112-2027 Job Title:Asst Director Patient Care Location:Newark Beth Israel Medical Ctr Department...you need. Required Certifications and Licenses: + Active NJ RN License or Multistate RN License with… more
    RWJBarnabas Health (10/27/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Associate…

    Banner Health (Fallon, NV)
    …dinner, and entertainment. Banner Churchill Community Hospital is looking for a full-time Registered Nurse Associate Director to oversee the MedSurg, ICU ... unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and evaluating quality and process… more
    Banner Health (10/22/25)
    - Save Job - Related Jobs - Block Source
  • Inpatient Social Worker (MSW) or Registered

    St. Luke's University Health Network (Stroudsburg, PA)
    …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director . . Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
    St. Luke's University Health Network (11/03/25)
    - Save Job - Related Jobs - Block Source
  • Inpatient Social Worker (MSW) or Registered

    St. Luke's University Health Network (Bethlehem, PA)
    …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director . + Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
    St. Luke's University Health Network (10/15/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Associate…

    Banner Health (Torrington, WY)
    …of recreational opportunities. Torrington Community Hospital is looking for a full-time RN Associate Director to lead the Emergency department in Torrington, ... a state-of-the-art emergency department, electronic medical records and a computerized OB system designed to reduce the chances of complications during labor and… more
    Banner Health (09/19/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Associate…

    Banner Health (Susanville, CA)
    …(https://youtu.be/sTPoc9EbJ\_Y) Banner Lassen Medical Center is looking for an Associate Director to have direct oversight of the PeriOperative Department in ... 40-hours per week will attend key facility, regional and system meetings. You will be required to gown up...ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and evaluating… more
    Banner Health (11/09/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Registered Nurse

    Cognizant (Annapolis, MD)
    …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in… more
    Cognizant (11/15/25)
    - Save Job - Related Jobs - Block Source