Utilization Management Jobs in USA

Required Qualifications Education & Certification MD or DO from an accredited medical school Board Certified in one of the following: Internal Medicine OR Endocrinology OR Family Medicine/Family Practice Active and unrestricted medical license (state to be confirmed) DEA licensure Experience M...

About the role: As a Provider Engagement Associate Consultant you will support the development and maintenance of strong collaborative relationships with health care organizations participating in Wellmarks partnership with Provider Engagement leadership and Provider Engagement Consultants (PECs) y...

The Practice Success Manager serves as the operational owner of assigned provider relationships across Guidehealths partner networks ensuring successful engagement sustained performance and accountability at the practice level. This role functions as the primary operational and relationship partner...

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...

Make it happen atHOPKINS!This position is eligible for remote work if you live in one of the following states: Maryland Virginia Delaware Pennsylvania Florida or Washington DC.Full-TimeShift: DayThe mission of Johns Hopkins Medicine is to improve the health of the community and the world by setting...

Job Requisition ID:56519Opening Date: 06/08/2026Closing Date: 06/29/2026Agency:Department of Human ServicesClass Title:MEDICAL ADM II OPT D - 26403Skill Option:Special License - IL License to Practice Medicine - Family PracticeBilingual Option:NoneSalary: Anticipated Salary: $25092 - $27092 per mont...

Position Description:CGI is one of the largest independent IT and business consulting services firms in the world. Through industry expertise innovative technology solutions and a collaborative culture CGI helps clients across industries achieve measurable business outcomes while empowering professi...

Career CategorySales & Marketing OperationsJob DescriptionJoin Amgens Mission of Serving PatientsAt Amgen if you feel like youre part of something bigger its because you are. Our shared missionto serve patients living with serious illnessesdrives all that we do.Since 1980 weve helped pioneer the wor...

Position Summary - Director Market Access Payer & Provider Strategic Contract AnalyticsAt GSK we are focused on uniting science technology and talent to get ahead of disease together. As Director Market Access Payer & Provider Strategic Contract Analytics you will play a critical leadership role sha...

Anticipated End Date:Position Title:Medical Director New York CommercialJob Description:Medical Director New York Commercial Location: This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. Thi...

DSV - Global transport and logisticsIn 1976 ten independent hauliers joined forces and founded DSV in Denmark. Since then DSV has evolved to become the worlds 3rdlargest supplier of global solutions within transport and logistics. Today we add value to our customers entire supply chain by transporti...

DSV - Global transport and logisticsIn 1976 ten independent hauliers joined forces and founded DSV in Denmark. Since then DSV has evolved to become the worlds 3rdlargest supplier of global solutions within transport and logistics. Today we add value to our customers entire supply chain by transporti...

Supervisor Utilization Management Hybridrole(3days/weekin office)atourBurlington Renton Spokane Vancouver Portland Medford Salt Lake City Boise Lewiston or Fargooffices. Candidates mustresidewithin commutable distance of that location or be willing torelocate. Build a career with purpose. JoinourCau...

Who We ArePoint32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality affordable healthcare. Serving nearly 2 million members Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and em...

Utilization Management Inpatient Clinical SpecialistWork from home within Washington Oregon Idaho or UtahBuild a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.Who We Are Looking For:Every day Cambias dedicated team ofUtilization Manage...

The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters relating to patient care. The PA will partner to reduce length of stay ensure appropriate use of level of care determinations (inpatient observation outpatient and other classifications as identified) support...

Weve made a lot of progress since opening the doors in 1942 but one thing has never changed - our commitment to serve heal lead educate that every award earned every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner whether you work with...

Registered Nurse Case ManagerLocation: Santa Rosa California Apple Valley California Mission Viejo California Mission Hills California Eureka California Duration: 13 WeeksShift: Days (8:00 AM 4:30 PM) Schedule: 5x8sResponsibilitiesCoordinate patient care across the continuum to ensure quality...

OverviewHospital Name: OhioHealth Rehabilitation HospitalJoint venture/Partnership/Affiliation with Select MedicalPosition: Case ManagerLocation: Columbus OHSchedule:Per DiemCompensation: $40.00 per hourOur Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate car...

Employment Type:Full timeShift:Day ShiftDescription:This position coordinates care and service for defined patient populations across the acute care continuum. This includes discharge planning utilization management care coordination and support for resource utilization. This position works collabor...