• Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... more
    New York State Civil Service (03/04/25)
    - Save Job - Related Jobs - Block Source
  • BCBA Utilization Review

    Intermountain Health (Murray, UT)
    …+ Occasional travel to provider locations within Select Health region. ** Utilization Review and Care Management:** + ** Review and Analysis:** ... more
    Intermountain Health (02/06/25)
    - Save Job - Related Jobs - Block Source
  • RN - Utilization Review

    Health Advocates Network (Medford, OR)
    Health Advocates Network is urgently hiring Discharge Planning and Utilization Review Registered Nurses (RNs) in the Medford, OR area. Must have 2 years of ... more
    Health Advocates Network (02/08/25)
    - Save Job - Related Jobs - Block Source
  • Physical Therapy Utilization Review

    Sedgwick (Memphis, TN)
    …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Physical Therapy Utilization Review Advisor **PRIMARY PURPOSE** **:** Counsels providers ... more
    Sedgwick (03/26/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Reviewer I/II/III,…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or otherwise ... more
    Excellus BlueCross BlueShield (03/05/25)
    - Save Job - Related Jobs - Block Source
  • Talent Utilization Coordinator Sr Manager

    Huron Consulting Group (Chicago, IL)
    …our team as the expert you are now and create your future. The Talent Utilization Coordinator will serve as the lead for managing staffing and utilization across ... more
    Huron Consulting Group (02/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse Consultant-…

    CVS Health (Olympia, WA)
    …cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong ... more
    CVS Health (03/19/25)
    - Save Job - Related Jobs - Block Source
  • Market Director of Utilization Management

    Ascension Health (Nashville, TN)
    …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... more
    Ascension Health (01/24/25)
    - Save Job - Related Jobs - Block Source
  • Integrated Care Management Assistant…

    McLaren Health Care (Detroit, MI)
    … records/billing or healthcare related field + Two years of case management or utilization review , billing, or coding experience + Three years of recent ... more
    McLaren Health Care (01/13/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Behavioral Health…

    Humana (Columbus, OH)
    …problem-solving skills, facilitation skills **Preferred Qualifications** + Experience with utilization review process + Experience with behavioral change, ... more
    Humana (03/15/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Utilization Reviewer, LPN

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …external facility or providers as needed to gather clinical information to support the medical necessity review process and plan of care. + Support a positive ... more
    Blue Cross Blue Shield of Massachusetts (02/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse - US Air Force

    Katmai (Usaf Academy, CO)
    …need for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring ... more
    Katmai (01/18/25)
    - Save Job - Related Jobs - Block Source
  • LVN- Medical Specialties Float Pool - SRS…

    Sharp HealthCare (San Diego, CA)
    …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... more
    Sharp HealthCare (03/04/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Inpatient…

    Molina Healthcare (Columbus, OH)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... more
    Molina Healthcare (03/23/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, PA (RN) - Transplant…

    Molina Healthcare (Columbus, OH)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... more
    Molina Healthcare (03/07/25)
    - Save Job - Related Jobs - Block Source
  • Corporate Account Manager Travel Retail…

    The Estee Lauder Companies (Miami, FL)
    Estee Lauder Companies Travel Retail Americas is looking for their next Corporate Account Manager **Description** The key objectives of this role is to manage and ... more
    The Estee Lauder Companies (01/28/25)
    - Save Job - Related Jobs - Block Source
  • Medical Director, Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …II (in addition to Level I Qualifications) + Minimum 2-3 years of experience in medical management, utilization review and case management. + Knowledge of ... more
    Excellus BlueCross BlueShield (02/19/25)
    - Save Job - Related Jobs - Block Source
  • Application Review Analyst - Full Time,…

    Guidehouse (San Antonio, TX)
    **Job Family** **:** Business Operations ** Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** Guidehouse is seeking ... more
    Guidehouse (03/07/25)
    - Save Job - Related Jobs - Block Source
  • RN Uniform System Assessor field travel

    Molina Healthcare (Albany, NY)
    …community and accessing and using durable medical equipment (DME). * Experience in utilization review , concurrent review and/or risk management a plus. * ... more
    Molina Healthcare (03/19/25)
    - Save Job - Related Jobs - Block Source
  • Physician Advisor - Houston Methodist

    Houston Methodist (The Woodlands, TX)
    …the liaison to other medical staff committees that interface with the utilization review /management committee. Assist with the evaluation of the hospital's ... more
    Houston Methodist (02/13/25)
    - Save Job - Related Jobs - Block Source