- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Jan 6, 2026 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... services, health care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of utilization review,… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
- Elevance Health (Washington, DC)
- …4 days each week. The office is located at 609 H. Street NE.** The **RN** ** Manager - Utilization Management ** is responsible for managing a team of physical ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... professionals to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... (BSN) degree required + Five or more years of utilization management required + Four or more...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed… more
- Elevance Health (CA)
- **Behavioral Health Care Manager I, Utilization Management ** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... is granted as required by law. The **Behavioral Health Care Manager I, Utilization Management ** is responsible for managing psychiatric and substance… more
- Centene Corporation (New York, NY)
- …Review Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Manages prior authorization, concurrent review, and retrospective clinical review team and ensures… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and...Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred… more
- Prime Healthcare (Sherman Oaks, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization - management ... Healthcare Workers Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost… more
- Evolent (Annapolis, MD)
- …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- John Muir Health (Walnut Creek, CA)
- …the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** + ... manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager ...Support - American Heart AssociationRequired + ACM Accredited Case Manager - ACMA American Case Management Association… more
- CVS Health (Austin, TX)
- …states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for telephonically and/or ... heart, each and every day. **Position Summary:** This Case Manager RN position is with Aetna's National Medical Excellence...practice experience as an RN - 6+ months Case Management or Utilization Management experience… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
- Logan Health (Kalispell, MT)
- …Excellence. Logan Health is looking for an RN to lead the way as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review! This role is ideal ... workflows with clarity. What You'll Be Doing: As the Manager of CDI & Utilization Review, you...manner + Partnering with the Chief Medical Officer on utilization review initiatives, length of stay management ,… more
- Cedars-Sinai (Los Angeles, CA)
- …Case Manager - PER DIEM - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Patient ... **What will you be doing in this role?** The Utilization Review Case Manager validates the patient's...Association or American Red Cross required + Certified Case Management RN preferred **Experience:** + A minimum of 5… more