• Harbor Health Services, Inc. (Mattapan, MA)
    …regulatory entities. Collaborates with Senior Medical Director to resolve complex medical review issues and utilization cases requiring elevation to the Senior ... 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an...Ensures timely responses to all requests related to medical review decisions and authorization issues from EOHHS, CMS and… more
    job goal (12/10/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Analyst

    Beth Israel Lahey Health (Burlington, MA)
    …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management ... necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue...intensity of medical care provided. . **Job Description:** The Utilization Analyst works with physicians, the payers… more
    Beth Israel Lahey Health (10/30/25)
    - Save Job - Related Jobs - Block Source
  • Medicaid Utilization Analyst 12…

    State of Michigan (Lansing, MI)
    Medicaid Utilization Analyst 12 - HSA Psychotropic Medication Oversight Unit (FC-PMOU) Print ... (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5143934) Apply  Medicaid Utilization Analyst 12 - HSA Psychotropic Medication Oversight Unit… more
    State of Michigan (12/14/25)
    - Save Job - Related Jobs - Block Source
  • Senior Business Analyst

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Blue Cross and Blue Shield of Minnesota Position Title: Senior Business Analyst - Utilization Management Location: Hybrid | Eagan, Minnesota Career ... business solutions through research, audit, and analysis of data for Utilization Management. Your Responsibilities * Participates in process change and redesign… more
    Blue Cross and Blue Shield of Minnesota (11/01/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (10/06/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… more
    The County of Los Angeles (09/27/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Specialist

    CaroMont Health (Gastonia, NC)
    …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... be cross trained to work for the Commercial Resource Analyst when the need arises. Act as liaison to...NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case… more
    CaroMont Health (10/11/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Clinician - ABA

    Centene Corporation (Phoenix, AZ)
    …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
    Centene Corporation (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
    Centene Corporation (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Predictive Data Analyst / Emergency…

    The County of Los Angeles (Los Angeles, CA)
    PREDICTIVE DATA ANALYST / EMERGENCY APPOINTMENT HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4775405) Apply  PREDICTIVE DATA ... ANALYST / EMERGENCY APPOINTMENT HOMELESSNESS Salary $94,477.20 - $127,316.88...and prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive… more
    The County of Los Angeles (12/13/25)
    - Save Job - Related Jobs - Block Source
  • Medical Review Analyst I

    Elevance Health (Norfolk, VA)
    **MEDICAL REVIEW ANALYST I** **Location:** This role requires associates to be in-office **1** day per week, fostering collaboration and connectivity, while ... accommodation is granted as required by law._ The **MEDICAL REVIEW ANALYST I** will be responsible for...and other internal departments. + Responsibilities exclude conducting any utilization or medical management review activities which… more
    Elevance Health (12/05/25)
    - Save Job - Related Jobs - Block Source
  • Portfolio Analyst / Senior Portfolio…

    Hawaiian Electric (Honolulu, HI)
    Portfolio Analyst / Senior Portfolio Analyst - Oahu Date:Dec 4, 2025 Location: Honolulu, Hawaii (HI), US, 96840 Company: hawaiianel We recognize our competitive ... vacancy available. (Role: Professional) This posting seeks to fill at either the Portfolio Analyst or Senior Portfolio Analyst ; whichever level is most suited to… more
    Hawaiian Electric (11/05/25)
    - Save Job - Related Jobs - Block Source
  • Strategic Pharmacy Analyst

    RxBenefits (Charlotte, NC)
    RxBenefits is hiring! We are adding a Strategic Pharmacy Analyst to our growing Business Development team. The Analyst will work closely with our Business ... Development team to achieve sales goals. The Analyst may work remotely or in our Birmingham, AL headquarters. The enhanced Strategic Pharmacy Analyst (SPA) team… more
    RxBenefits (12/04/25)
    - Save Job - Related Jobs - Block Source
  • (Senior) Compensation & HR Data Analyst

    Boston College (Chestnut Hill, MA)
    …**Please note: This position is not fully remote.** (Senior) Compensation & HR Data Analyst The Compensation & HR Data Analyst (or Senior Analyst , ... participation, and advisory support for HR liaisons, managers, and recruiters. The Analyst /Senior Analyst gathers and interprets complex HR data, develops… more
    Boston College (12/09/25)
    - Save Job - Related Jobs - Block Source
  • Analyst - Accessibility Review

    Texas Tech University (Lubbock, TX)
    **43235BR** **Extended Job Title:** Analyst - Accessibility Review **Position Description:** Analyzes and coordinates office services such as personnel, budget ... preparation and control, fiscal affairs, equipment utilization , records control, and special management studies. **Requisition ID:** 43235BR **Travel Required:**… more
    Texas Tech University (12/16/25)
    - Save Job - Related Jobs - Block Source
  • Loan Review Analyst

    Wright-Patt Credit Union Inc. (Beavercreek, OH)
    The Loan Review Analyst provides continuous review of the quality and performance of loan originations and collection efforts for the Credit Union's consumer ... to the consumer lending program. Monitors the credit risk review process and the lending process as a whole...monitoring of key trends such as origination volume, line utilization , loan pay downs, and other data to provide… more
    Wright-Patt Credit Union Inc. (12/10/25)
    - Save Job - Related Jobs - Block Source
  • Staff Analyst , Health / Emergency…

    The County of Los Angeles (Los Angeles, CA)
    STAFF ANALYST , HEALTH / EMERGENCY APPOINTMENT HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4264710) Apply  STAFF ANALYST , ... of Public Health is seeking qualified candidates to fill emergency Staff Analyst , Health vacancies related to the homelessness crisis. Under the emergency order,… more
    The County of Los Angeles (11/27/25)
    - Save Job - Related Jobs - Block Source
  • Production Analyst -Task Group Naval…

    CACI International (Pensacola, FL)
    …management systems including the NAPP Integrated Production Data Repository (NIPDR). The analyst will review statistical data looking for errors and erroneous ... Production Analyst -Task Group Naval Aircrew (TG NAC) Job Category:...+ Provide analysis and recommendation regarding production and resource utilization through interpretation of NAPP/NIPDR charts. Monitor Command production… more
    CACI International (10/28/25)
    - Save Job - Related Jobs - Block Source
  • Application Analyst II

    HCA Healthcare (Nashville, TN)
    …satisfaction and personal growth, we encourage you to apply for our Application Analyst II opening. We promptly review all applications. Highly qualified ... and integrity. We care like family! Jump-start your career as an Application Analyst II today with HCA Healthcare. **Benefits** HCA Healthcare offers a total rewards… more
    HCA Healthcare (11/23/25)
    - Save Job - Related Jobs - Block Source
  • Senior Purchased Services Analyst

    HCA Healthcare (Nashville, TN)
    …to join an organization that invests in you as a Senior Purchased Services Analyst ? At HealthTrust, you come first. HCA Healthcare has committed up to $300 million ... We are looking for a dedicated Senior Purchased Services Analyst like you to be a part of our... supports sourcing projects by coordinating the analytics team's review of multiple agreements within a category to establish… more
    HCA Healthcare (10/31/25)
    - Save Job - Related Jobs - Block Source