The Utilization Management Manager at Dartmouth Health is responsible for overseeing the utilization review program across multiple hospitals, ensuring regulatory compliance and appropriate financial outcomes. This role involves collaboration with program medical directors, care teams, and health plans, as well as leading departmental performance improvement activities. The position offers the option to be fully remote and requires strong communication and analytical skills.

Utilization Management, Manager. Registered Nurse, RN

Utilization Management Manager, Registered Nurse

Join Burrell Behavioral Health as a Nurse Care Manager, a role that involves making a meaningful impact on patient health outcomes by providing vital education and support to clients with complex medical conditions. This remote position, based in Joplin, Missouri, offers the opportunity to work with a multidisciplinary team, develop wellness and prevention initiatives, and advance your career in a supportive environment. The role includes developing personalized treatment plans, facilitating health education groups, managing hospital admissions and discharges, and implementing health technology programs.

DD Nurse Care Manager-RN/LPN -Hybrid (Joplin and surrounding areas)

Nurse Care Manager

The Case Manager 2 at Public Consulting Group is responsible for guiding program recipients, family members, and caretakers through the healthcare benefits system. This role involves developing program policies and procedures, managing the full patient care cycle, and ensuring client-centered care. The position requires travel within the state for in-person assessments and involves coordinating care, facilitating multiple care aspects, and acting as an advocate for patients.

Western New York Licensed Nurse Case Manager

Case Manager 2

The Care Manager at CareFirst is responsible for researching and analyzing members' medical and behavioral health needs and healthcare cost drivers. They work closely with members and the interdisciplinary care team to ensure an effective plan of care and positive member experience, leading to optimal health and cost-effective outcomes. This role involves identifying members with acute/complex conditions, engaging with them and their providers to develop comprehensive care plans, and facilitating program and community referrals.

Care Manager (MD-DC-Northern VA) (Remote)

Care Manager

The Care Manager at Magellan Health Services is responsible for authorizing and reviewing utilization of mental health and substance abuse services in both inpatient and outpatient care settings. This role involves collecting and analyzing utilization data, assisting with discharge planning and care coordination, providing member assistance with mental health and substance abuse issues, and participating in special quality improvement projects. The position requires collaboration with other clinical team members, interaction with Physician Advisors, and participation in network development activities.

Care Manager (UM/UR) - Remote, Idaho Licensed

The Senior Case Manager at Samaritan Daytop Village is responsible for aiding clients requiring social service assistance. This role involves interviewing and evaluating clients, formulating Independent Living Plans, locating and utilizing community resources, and relocating clients to permanent housing. The position supports the mission and goals of Samaritan Daytop Village and requires collaboration with clients and direct supervision of Case Managers.

Senior Case Manager

TorkLaw is seeking a motivated and self-starting Personal Injury Case Manager responsible for handling the pre-litigation phase of personal injury cases from inception to settlement. This role involves establishing relationships with clients, attorneys, and support teams, extensive communication with insurance adjusters and medical providers, and managing all aspects of pre-litigation cases. The ideal candidate is kind, compassionate, service-oriented, and possesses excellent communication and organizational skills.

Case Manager for a Personal Injury Firm (Work from Home)

Personal Injury Case Manager

The Clinical Operations Supervisor - RN at Acentra Health is responsible for managing the day-to-day operations of Clinical Operations, Utilization Management, and Clinical Reviewers. This role involves assuring quality customer service and support for clients and staff, developing and enforcing operational policies and procedures, managing staff, and coordinating correspondence between external stakeholders and the company. The position requires a proactive approach to problem-solving, team management, and ensuring operational success through business and financial metrics monitoring.

Clinical Operations Supervisor

Clinical Operations Supervisor - RN

Molina Healthcare Services (HCS) works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. This role supports the Senior Whole Health business, focusing on Managed Long-Term Care (MLTC) plans, and requires a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization Management (UM) and MLTC/LTC experience are highly preferred. The position is remote with light travel for in-person meetings, and offers a competitive benefits and compensation package.

UM Care Review Clinician PA MLTC RN Remote in New York

UM Care Review Clinician RN

The Care Manager Specialist at CVS Health is a key member of the Care Team, responsible for the care management of members enrolled in the Dual Special Needs Plan with limited health conditions. This role involves assessing member needs, gaps in care, communicating with Primary Care Providers, maintaining updated care plans, and participating in interdisciplinary team meetings. The specialist works closely with other team members to improve health outcomes, address social determinants of health, and connect members with community-based organizations.

Analyst, Case Mgmt Specialist

Analyst, Case Management Specialist

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