Utilization Management Jobs in USA

Full Time 10am-10pm The Lead ED Quality Utilization Specialist reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards....

At GSK we have bold ambitions for patients aiming to positively impact the health of 2.5 billion people by the end of the decade. Our R&D focuses on discovering and delivering vaccines and medicines combining our understanding of the immune system with cutting-edge technology to transform peoples li...

AHCCCSArizona Health Care Cost Containment SystemAccountability Community Innovation Leadership Passion Quality Respect Courage TeamworkThe Arizona Health Care Cost Containment System (AHCCCS) Arizonas Medicaid agency is driven by its mission to deliver comprehensive cost-effective health care to Ar...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

About Blue Cross and Blue Shield of MinnesotaAt Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate...

Lifekind Health is looking for an experienced Licensed Clinical Social Worker (LCSW) or Licensed Marriage & Family Therapist (LMFT) to join our team full-time. Deliver evidence-based psychological and behavioral health services to patients receiving care in a transdisciplinary pain management settin...

Anticipated End Date:Position Title:Behavioral Health Clinical AuditorJob Description:Behavioral Health Clinical Auditor Location: It is highly preferred that the selected candidate reside within commutable distance to a PulsePoint.Virtual: This role enables associates to work virtually full-time ex...

UTILIZATION REVIEW NURSE LEADHYBRID must be able to travel to 3031 NE STEPHENS ST. ROSEBURG OR 97470EMPLOYMENT TYPE: Full-Time ExemptAbout Umpqua HealthAt Umpqua Health were more than a healthcare organizationwere a community-driven Coordinated Care Organization (CCO) dedicated to improving the heal...

Anticipated End Date:Position Title:LTSS Service Coordinator (Case Manager)Job Description:LTSS Service Coordinator (Case Manager)Hiring statewide across Ohio. Must reside in the state of Ohio.Location: This field-based role enables associates to primarily operate in the field traveling to client si...

Job Description:Industry: Healthcare / Health Services - Hospital AdministrationJob Category: Medical / Health - Administration The individual in this position has overall responsibility for hospital utilization management transition management and operational management of the Case Management Depar...

Job Description:Industry: Healthcare / Health Services - Hospital AdministrationJob Category: Medical / Health - AdministrationAre you a results-driven leader ready to make a meaningful impact to patients caregivers and your community At DMC Detroit Receiving Hospital we re seeking an innovative a...

Role Descriptions: Health Cloud Location: Indianapolis IN Health Cloud Data Modelso Patients Care Program Care Program Enrollee Care Program EnrolleeProduct Health Cloud Console configuration Amazon call connect Conga Composer to design and send email/fax templates Email to CaseWeb to Case and Vani...

This position is in the ED: 6:00pm -2:00AM. Monday through Friday.  No weekends /holidays. This is not a remote position.  The Utilization Management RN reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all rel...

Employment Type:Full timeShift:Day ShiftDescription:RN Case Management for ED/Observation Full Time Days/12hr shifts If you are looking for an RN position in Case Management and a regular schedule is your preference this could be your opportunity. Here at St. Peters Health Partners we care for more...

Inspire health. Serve with compassion. Be the difference.Job SummaryProvides assistant surgical services in the operating room as well as other selected medical services under the direction of the surgeon.Accountabilities* Provides general surgical assistant services in operating room.10%* Assists...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

**Recruiting only in the following counties of Michigans Upper Peninsula: Chippewa Luce or Mackinac**DATE: May 6 2026POSITION: Remote Community Based Clinical Coordinator - Care ManagerDEPARTMENT: Clinical ServicesRATE: $29.72 per hour with potential for additional compensation based on qualificatio...