• Minnesota Department of Natural Resources - Division… (Blackduck, MN)
    …Job Summary The DNR, Division of Forestry is seeking to fill a Forestry Specialist position in Blackduck, MN. Depending on internal movement, this posting may be ... application process, candidates will choose their preferred location(s). The Forestry Specialist position exists to implement program support tasks across all… more
    Appcast IO CPC (01/04/26)
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  • PRN Clinical Utilization Review…

    Community Health Systems (Franklin, TN)
    **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization more
    Community Health Systems (12/03/25)
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  • Utilization Management Specialist

    FLACRA (Clifton Springs, NY)
    Utilization Management Specialist FLACRA Clifton Springs, NY (Onsite) Full-Time $16.50 - $17.50/Hour Apply Now ... (https://flacra.jobs.net/apply/jqn6gn6t2h294xv9ngh?ipath=CR¬ify=true&siteid=cbnsv) Job Details Job Title: Utilization Management Specialist Location:Finger Lakes Region, NY… more
    FLACRA (12/19/25)
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  • Utilization Management Specialist

    Penn Medicine (Lancaster, PA)
    …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... pressure, we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible for evaluating medical records to… more
    Penn Medicine (12/24/25)
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  • Physician Utilization Review…

    Hackensack Meridian Health (Hackensack, NJ)
    **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... and Hackensack UMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of… more
    Hackensack Meridian Health (11/12/25)
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  • Utilization Management Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
    Mount Sinai Health System (01/02/26)
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  • ABA Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist ... software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR… more
    Spectrum Billing Solutions (10/30/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
    BriteLife Recovery (01/05/26)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (12/20/25)
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  • Utilization Management Specialist II

    AnMed Health (Anderson, SC)
    …This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These duties ... continued stay/concurrent review, retrospective review, bed status management, resource utilization management, regulatory compliance, and related denial management issues.… more
    AnMed Health (11/13/25)
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  • Utilization Review Specialist

    TEKsystems (Los Angeles, CA)
    …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... + Active LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
    TEKsystems (12/31/25)
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  • Utilization Review Specialist

    WestCare Foundation (Henderson, NV)
    …or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or ... substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
    WestCare Foundation (11/13/25)
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  • Support Specialist - Utilization

    Henry Ford Health System (Troy, MI)
    The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. ... Epic preferred. Additional Information + Organization: Corporate Services + Department: Central Utilization Mgt + Shift: Day Job + Union Code: Not Applicable… more
    Henry Ford Health System (12/23/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to… more
    UnityPoint Health (11/07/25)
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  • Acquisition Specialist

    American Management Group, LLC (AMG) (Los Angeles, CA)
    …procurement of goods and services to support healthcare operations. The Acquisition Utilization Specialist serves as the primary liaison between program offices, ... Acquisition Specialist Los Angeles, CA Apply Now Acquisition Specialist Work Location: VA Greater Los Angeles Healthcare System-11301 Wilshire Blvd, Los Angeles,… more
    American Management Group, LLC (AMG) (01/08/26)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management... Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals activities. This… more
    Community Health Systems (11/22/25)
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  • UM Coordinator - Utilization Management

    Penn State Health (Hershey, PA)
    …(MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Under the direction of a Utilization Management Nurse or Specialist , the Utilization ... or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey | Clerical and Administrative |… more
    Penn State Health (01/08/26)
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  • Certified Peer Specialist , Full-Time Days

    St. Luke's University Health Network (Sellersville, PA)
    …partners with participants to facilitate their recovery and community integration through utilization of the Specialist 's personal life experience and first-hand ... ability to pay for health care. The Certified Peer Specialist (CPS) has the lived experience of a mental...educational courses and self-help groups. + Identify and promote utilization of natural community resources that support peers' goals… more
    St. Luke's University Health Network (12/10/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Los Angeles, CA)
    …registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review, informatics RN, Quality, DRG Validation ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...financial concerns and other business controversy. A Clinical Documentation Specialist (CDS) works to ensure accuracy and completeness of… more
    Deloitte (11/21/25)
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  • Community Health Specialist , Safe Options…

    Breaking Ground (Queens, NY)
    …homelessness history, services needed, and appropriate placement options. The Community Health Specialist ensures the utilization of Harm Reduction and Housing ... Director, Programs, Safe Options Support t he Community Health Specialist , Safe Options Support (SOS) provides on-site and...the highest quality care for clients. The Community Health Specialist carries a caseload and is responsible for ensuring… more
    Breaking Ground (01/08/26)
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