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Overview: Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for med

GENESIS HEALTHCARE SYSTEM In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable hea

Position Summary: Responsible for the coordination of case management strategies pursuant to the Case Management process. Assists and coordinates care of the patient from pre-hospitalization through d

The Director Utilization Management is responsible for oversight and management of all utilization review/case management activities for the facility's inpatient, partial hospitalization, and outpatie

Employment Type:Full time Shift:Description:Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We'r

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading hea

Accolade Healthcare Utilization Management/Case Manager About UsAt Accolade Healthcare, we put an emphasis on the satisfaction of our team members, understanding that a foundation built on quality pat

Employment Type: Full timeShift: Description: Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United State

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading hea

Job Type: Full-timeSchedule: Tuesday - Saturday OR Sunday - Thursday 8:00 AM – 5:00 PM (PST)Location: Anywhere in the US, Remote (California RN or LVN license required) Job SummaryMUST HAVE CALIFORNIA

Utilization Management Representative III Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility a

Anticipated End Date: Position Title: Utilization Management Representative II Job Description: Utilization Management Representative II Virtual: This role enables associates to work virtually

Anticipated End Date: Position Title: Utilization Management Rep I (US)Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-ti

Location: Bakersfield, CA Work Location: Primarily in-office. This position may require travel to various company locations, including clinics or administrative offices, based on operational needs. Cl

Department/Unit: Care Management/Social WorkWork Shift: Day (United States of America)Salary Range: $71, $110,999.20Responsible for Utilization Management, Quality Screening and Delay Management for a

Utilization Specialist - Acute | Carolina Dunes Behavioral Health | Leland, North Carolina About the Job: The Utilization Specialist is responsible for reviewing of assigned admissions, continued stay

Job Details Job Location: Admin 3 - Idaho Falls, ID 83404 Position Type: Full Time Education Level: Accredited Nursing Program Job Category: Health CareMountain View Hospital is looking for a Utiliza

:Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse (UR Nurse), you'll play an important role in helping us offer cus

For more specific/detailed information about this position, please see "additional job description". The Program Manager/banking AVP provides full leadership and supervisory responsibility. Provides o

For more specific/detailed information about this position, please see "additional job description". The Program Manager/banking AVP provides full leadership and supervisory responsibility. Provides o

Position Overview The Office of General Counsel (OGC) is responsible for providing expert advice of counsel and legal representation to DCPS' Chancellor, Central Office, principals, and other school-b

Position Summary... What you'll do...Drives the execution of multiple business plans and projects by identifying customer and operational needs developing and communicating business plans and prioriti

Compensation Grade: S22 Salary Range: $116,941.00-$169,563.00 Opening Date: November 21, 2025 Closing Date: December 6, 2025 Please Note: All job announcements close at 11:59 p.m. of the day before th

Copper Springs East Job Title: Utilization Review Specialist Job Type: Full-time Your experience matters At Copper Springs East, we are committed to empowering and supporting a diverse and determined

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body