Utilization Management Jobs in USA

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...

Anticipated End Date:Position Title:LTSS Service Coordinator - Summit/Stark/Wayne CountiesJob Description:LTSS Service Coordinator (Case Manager)Candidates must live in one of the following counties: Summit Stark or Wayne County.Location: This field-based role enables associates to primarily operate...

Classification Title:Chief Addiction Medicine Division / Associate or Full Professor Medical Director Florida Recovery Center (FRC)Job Description:The Department of Psychiatry at the University of Florida (UF) College of Medicine in Gainesville is seeking a Chief of the Addiction Medicine Division w...

Anticipated End Date:Position Title:Medical Director Genetic Testing OncologyJob Description:Medical Director Genetic Testing Oncology Location: This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and aut...

UTILIZATION REVIEW SPECIALIST 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...

Our client is a trusted and established manufacturer of custom cultured marble fixtures serving the St. Louis metropolitan area since 1978. Known for its commitment to quality craftsmanship and customer satisfaction the company offers a wide range of products including countertops vanities and showe...

Employment Status:Full timeShift:Weekends Only (United States of America)Facility:390 S Main St - Rocky MountRequisition Number:R160080 RN Case Manager - Weekends - Carilion Franklin Memorial Hospital (Open) How Youll Help Transform Healthcare:The RN Case Manager provides case management fo...

Role Summary We are seeking an experienced Epic Tapestry Utilization Management Analyst to design build optimize and support UM processes focused on authorizations and referrals. The ideal candidate is Epic Tapestry UM Certified has practical experience with Tapestry Care Link and is adept at transl...

The Associate Director Market Access Analytics is a senior individual contributor within Insights & Analytics exclusively dedicated to partnering with Sobi North Americas Market Access teams. Reporting to the Director Field Excellence & Market Access Analytics this role serves as the analytics thoug...

Cost Center163 Utilization ManagementScheduled Weekly Hours0Work ShiftShift & StatusWho Are WeWe at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest no...

Job DescriptionGeneral Summary:The Senior Medical Director will define the clinical development strategy of an asset work with cross-functional multidisciplinary teams to define overall asset strategy as well as clinical trials strategy design and execution and may serve as the Medical Lead for clin...

Employment Type:Full timeShift:Description:This position manages the activities of the Health Plan Clinical Services Team to ensure the achievement of department and company goals. The Clinical Manager will be responsible for overseeing the day-to-day clinical operations of the health plan including...

Hours:Shift Start Time:8 AMShift End Time:4:30 PMAWS Hours Requirement:8/80 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:No WeekendsOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$61.740 - $70.170 - $90.160The stated pay scale reflects the range as defined by t...

Position Title: Registered Nurse Case Manager Location: Eureka California Pay Rate (Local):Up to $55.00/hour Pay Rate (Travel):Up to $70.00/hour Weekly Hours: 40 hours Schedule: Night Shift (5x8s) 07:00 PM 07:00 AM Every other weekend Assignment Duration: 13 weeks (with potential for extension)P...

OverviewCommunity Focused. Care Driven.Join Southcoast Health where your future is as promising as the care we provide. Our commitment to each other our patients and our community is more than a mission - its our way of life and youll be at the heart of it.Southcoast Health is a not-for-profit chari...

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...

Astrana Health is looking for a RN/LVN Case Manager who has the ability to commute to our Monterey Park office at 1600 Corporate Center Drive. This position works standard day hours M-F and we are willing to train a RN or LVN with no case management experience! You will have the ability to work with...