• Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization more
    Prime Healthcare (10/18/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... The Executive Director works closely with leaders from various departments- case management , physician advisors, revenue cycle, medical staff, nursing, and… more
    UNC Health Care (10/29/25)
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  • Director , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …responsibility for managing the effective utilization of healthcare services, case / disease management , program development/ management /evaluation and ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
    Commonwealth Care Alliance (10/02/25)
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  • Utilization Management Medical…

    Elevance Health (Durham, NC)
    ** Utilization Management Medical Director - NC...The **Medical Director ** will be responsible for utilization review case management for North ... May serve as a resource to staff including Medical Director Associates. **How you will make an impact:** +...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
    Elevance Health (11/12/25)
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  • Senior Utilization Review Medical…

    Integra Partners (Troy, MI)
    …Medicaid, and all federally funded programs; no OIG sanctions + 5+ years of utilization management experience, including complex case review + Prior ... (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+… more
    Integra Partners (12/03/25)
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  • Utilization Review Medical Director

    Integra Partners (Troy, MI)
    …of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions ... The Utilization Review Medical Director is responsible...or past OIG or state sanctions + Experience performing utilization management or clinical review activities +… more
    Integra Partners (12/02/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
    Wellpath (11/07/25)
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  • LPN- Utilization Mgmt Reviewer…

    Guthrie (Cortland, NY)
    Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of...with members of the healthcare team. + Proactively researches case findings related to payer audits of UM decisions… more
    Guthrie (10/28/25)
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  • Utilization Review Case Mgr - CMC…

    UTMB Health (Webster, TX)
    …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
    UTMB Health (11/21/25)
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  • Director Utilization

    Healthfirst (NY)
    …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
    Healthfirst (12/04/25)
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  • Senior Director Case

    Houston Methodist (Houston, TX)
    …for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the ... At Houston Methodist, the Sr Director Case Management position... initiatives. + Provides strategic vision and execution for case management and utilization review… more
    Houston Methodist (10/16/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is...resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring… more
    Brockton Hospital (09/12/25)
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  • Director - Case Management

    Tenet Healthcare (Detroit, MI)
    Director - Case Management -...Oversees hospital utilization performance improvement and operational management of the site Case Management ... services. Integrates national standards for case management scope of services including: * Utilization ... utilization of resources * Provides education to case management staff, physicians, and the healthcare… more
    Tenet Healthcare (12/02/25)
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  • Director Case Management

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Director Case Management & Social Services RN position is responsible for strategy, function and operations of the Case ... cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys...a voice for the department. + Sets direction for Case Management /Social Services which supports strategic and… more
    Houston Methodist (11/18/25)
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  • Director of Case Management

    Select Medical (Charleston, WV)
    **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Director of Case Management ** **Full Time: Monday - Friday ... doing well by doing what is right. As the Director of Case Management **,**...resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating… more
    Select Medical (12/06/25)
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  • Hospital Director of Case

    Select Medical (Madison, WI)
    **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **$10,000 Sign On Bonus** Pay Is Determined By Relevant Years of ... doing well by doing what is right. As the Director of Case Management **,**...resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating… more
    Select Medical (11/20/25)
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  • Director Case Management

    HCA Healthcare (Houston, TX)
    …**Introduction** Do you want to join an organization that invests in you as a Director Case Management ? At HCA Houston Healthcare Northwest, you come first. ... make a difference. We are looking for a dedicated Director Case Management like you...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
    HCA Healthcare (12/04/25)
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  • Director Case Management (RN)

    Nuvance Health (Danbury, CT)
    …our entire community makes this a truly special place to work. Summary: The Director of Case Management provides strategic leadership and operational ... oversight for the hospital case management program. This role is responsible...care coordination, discharge planning, and transitions of care. The Director ensures compliance with regulatory requirements, promotes patient-centered care,… more
    Nuvance Health (10/23/25)
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  • Director of Case Management

    Select Medical (Henderson, NV)
    **Overview** **Dignity Health Rehabilitation Hospital** _Partnership with Select Medical_ **Position:** Director of Case Management **Location:** Henderson, ... management criteria, and implementation of safe and appropriate discharge plans. The Director of Case management is also responsible for maintaining a… more
    Select Medical (11/14/25)
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  • Interim Director of Case

    HealthTrust Workforce Solutions (Bradenton, FL)
    …access to more than 200,000 jobs nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who participates as an active ... administrative member of the Nursing Management Team. The Case Management ... management , cost control, contract compliance, quality improvement, utilization management , denials management and… more
    HealthTrust Workforce Solutions (12/07/25)
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