• Alameda Health System (Oakland, CA)
    …Generous paid time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
    job goal (12/08/25)
    - Save Job - Related Jobs - Block Source
  • Saint Francis Health System (Tulsa, OK)
    …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location Tulsa, Oklahoma 74136 EOE Protected… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Gentiva (Jackson, MI)
    …Hospice Administrator to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... while driving branch revenue growth through census development, referral management , and efficient resource utilization Maintain strong...employer We maintain a drug-free workplace Related Job Titles RN Branch Director , RN Branch… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Baystate Health (Springfield, MA)
    …Master's preferred (MSN, MHA, MBA, or related field) or experience equivalent to Any registered nurse in the role either the bachelor's degree or master's Degree ... Minimum - Midpoint - Maximum $141,252.00 - $162,364.00 - $192,067.00 Summary: The Director , Central Staffing Office, is a key leadership role responsible at Baystate… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Organon & Co. (Raleigh, NC)
    …Structure and Function. Preferred Education, Experience and Skills PharmD, APRN, RN , MBA preferred. Previous large/strategic account management role. Contracting ... Job Description The Position The Regional Payer Account Director (RPAD) reports directly to the Executive ...as other extended account team members to maximize appropriate utilization of Organon products. Integrates Senior Leadership into the… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Beth Israel Lahey Health (Boston, MA)
    …Nursing Program required. Baccalaureate degree in Nursing strongly preferred. License Registered Nurse required. American Heart Association - Basic Life ... and Emergency Department. In absence of Admission Facilitator, directs bed utilization . Provides clinical consultation, support, education and mentoring to clinical… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Commonwealth Care Alliance (Boston, MA)
    …and member experience. Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised No, this… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Fresenius Medical Care North America (Albany, OR)
    …the daily operations of the dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care ... other related duties as assigned. PATIENT CARE Collaborates closely with the Charge RN , the Medical Director , and physicians regarding the direct patient care… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • UnitedHealth Group (Minneapolis, MN)
    …(or higher) Certified coder AHIMA (CCS, CCS-P) or AAPC certified coder (CPC, CPC-I) or Nurse ( RN , LPN) with unrestricted license 2+ years of experience as an ... and payment recommendation for claims This could include Medical Director /physician consultations, interpretation of state and federal mandates, applicable benefit… more
    job goal (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...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)
    …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
  • RN Utilization Management

    Trinity Health (Columbus, OH)
    …information technology, financial analysis, audit, provider relations and more. **Position Purpose** RN Utilization Management MCHP is responsible for the ... the UM Program and at the direction of the Director , Utilization Management . + Coordinates...Licensure / Certification: Current license to practice as a Registered Nurse in their home state or… more
    Trinity Health (12/08/25)
    - Save Job - Related Jobs - Block Source
  • Nurse Manager - Utilization Review

    Huron Consulting Group (Chicago, IL)
    …regulatory agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital ... staff and function for the system, reporting to the Director of Utilization Management within...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… more
    Huron Consulting Group (11/27/25)
    - Save Job - Related Jobs - Block Source
  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
    Prime Healthcare (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (10/03/25)
    - 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 Management / Leadership Status:Full-Time ... 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
  • 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 ... 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 ... 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, ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...improvement initiatives of the department in conjunction with the director . Seeks and utilizes input from staff and oversees… more
    Banner Health (09/19/25)
    - Save Job - Related Jobs - Block Source
  • Associate Director RN

    Banner Health (Phoenix, AZ)
    …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... **Banner Estrella Medical Center -** **Postpartum** team. The Nursing Associate Director provides leadership and operational oversight for nursing services, ensuring… more
    Banner Health (12/07/25)
    - Save Job - Related Jobs - Block Source