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OverviewSite: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers

Imagine a career at one of the nation's most advanced health networks.Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally

About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standar

The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization and a

Job SummaryThis Senior Director role over Complex Care Management (CCM) and Utilization Management (UM) is a strategic senior leader position that is responsible for designing, implementing, and optim

We’re seeking adedicated and detail-oriented Utilization Management Registered Nurse (UM RN)to join our growing healthcare team. In this role, you’ll perform bothinpatient and outpatient utilization r

Position Description Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with

RemoteJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:Capital Rx , a public benefit corporation delivering

Job Title: Utilization Management RN (Remote) | Baltimore, MD | $85K+Fully remote opportunity. Fast interview process.Location:Baltimore, MD (Remote – must reside in Maryland or hold compact license)J

OverviewPosition SummaryThe Clinical Specialist reports to the Assistant Manager, Medical Management and provides clinical decision-making support and community resource coordination in support of Com

Utilization Management RN - Behavioral Health (OR Licensed)Position Responsibilities SpecificDetermine appropriateness of services through the application and evaluation of medical guidelines, benefit

CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of cl

Job Description Must reside in FloridaJob Summary Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization manag

About NYC Health + HospitalsMetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of produ

## Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)Applyremote type:Fully Remotelocations:Anywhere in the U.S.time type:Full timeposted on:Posted Yesterd

Quantum Corporation is seeking a Pre-Cert Pharmacy Review Nurse, RN for their healthcare navigation team. The role involves reviewing specialty medications and collaborating with multidisciplinary tea

BlueCross BlueShield of South Carolina is looking for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing complex claims and documenting

Job Responsibilities Core ResponsibilitiesChronic Disease ManagementDeliver ongoing care, support, and health education to participants with chronic illnesses including COPD, Diabetes, Heart Failure,

Summary of Job Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members' health care needs, ide

EmblemHealth is seeking a Care Manager in New York, NY, to provide care management as part of a multidisciplinary team. The ideal candidate will assess member needs and coordinate care, ensuring high-

Summary of PositionProvide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face‑to‑face assessments of members' health care needs,

Oscar Insurance Corporation (Oscar Health, Inc.) is seeking a full-time Remote Case Management Nurse. In this role, you will educate members on health outcomes, assist with care transitions, and colla

Carlsbad Tech is looking for a Nurse Case Manager II to join their remote team. The ideal candidate will utilize a collaborative process to assess and plan for individual benefit needs, ensuring optim

Compensation Range:$81,400 – $130,200 annually Compensation Type:Salary, with potential bonus based on company and individual performance Location:Remote (United States) Posted Date:July 28, 2025 Posi

Sr. Manager, Consulting - Asset Management & Investment Location: Remote - USType: Full-time, PermanentPlease note:This posting represents a pipeline role for upcoming consulting projects. We’re alway