Utilization Management

Cigna

Full-time · $141,500 – $235,900

This director-level role leads the global restructuring of Cigna's clinical workforce, building scalable delivery models across international locations while maintaining regulatory compliance and clinical quality. It suits experienced healthcare operations leaders comfortable driving large-scale transformation across complex stakeholder groups and shifting clinical work between geographies and vendor models.

Listed on Cigna’s careers site · Apply there ↗

Cambia Health Solutions

Part-time · $217,600 – $294,400

This part-time role oversees behavioral health utilization management and prior authorization decisions for a health plan, working with provider networks and internal teams to ensure clinically sound, cost-effective care. It suits experienced psychiatrists seeking flexible leadership work in healthcare administration without full-time commitment.

Listed on Cambia Health Solutions’s careers site · Apply there ↗

AdventHealth

Full-time · ADVENTHEALTH HEART OF FLORIDA · $32 – $56 / hour

A care manager working within a hospital setting to coordinate discharge planning, assess patient needs, and facilitate communication between patients, families, and clinical teams. This role suits experienced nurses interested in transitioning into care coordination and utilization management.

Listed on AdventHealth’s careers site · Apply there ↗

Elevance Health

Part-time · $178,135 – $290,438

This part-time medical director role oversees behavioral health utilization management for a California Medicaid plan, including peer-to-peer clinical reviews and serving as a clinical advisor to internal teams. The position suits psychiatrists with significant clinical experience who want flexible, leadership-oriented work in health plan administration without full-time commitment.

Listed on Elevance Health’s careers site · Apply there ↗

Cohere Health

Full-time · United States · $85,000 – $92,000

This role involves translating complex medical policies and coverage decisions into clear, patient-friendly communications that meet regulatory standards. It suits experienced medical writers or healthcare communicators who want to improve how patients understand their care options and coverage determinations.

Listed on Cohere Health’s careers site · Apply there ↗

Cambia Health Solutions

Full-time · $166,992 – $242,700

Lead clinical pharmacy operations and medication policy strategy for a large health plan, overseeing formulary development, prior authorization, and utilization management across multiple benefit types while managing a team and nearly $2 billion in annual drug spending. Suited to an experienced pharmacist leader with managed care expertise who wants to drive medication policy and clinical innovation in a mission-driven organization.

Listed on Cambia Health Solutions’s careers site · Apply there ↗

Elevance Health

Part-time

This role involves reviewing behavioral health service requests to determine medical necessity and appropriateness of care, primarily for autism spectrum disorder services, working virtually with clinical staff and medical directors. It suits licensed psychologists seeking part-time work in managed care utilization review with flexibility and subject matter expertise opportunities.

Listed on Elevance Health’s careers site · Apply there ↗

Cohere Health

Full-time · United States · $285,000 – $305,000

This role is for an experienced radiologist to serve as a clinical strategist and subject matter expert, shaping Cohere Health's diagnostic imaging offerings and go-to-market strategy for health plans and health systems. It suits someone with board certification and years of managed care or healthtech experience who wants to blend clinical expertise with business strategy and client partnerships.

Listed on Cohere Health’s careers site · Apply there ↗

Elevance Health

Full-time

This role leads telephonic and in-person care management for complex patients in a managed care setting, developing and coordinating treatment plans across the healthcare continuum. It suits experienced nurses with case management credentials who want to shift into care coordination and utilization management.

Listed on Elevance Health’s careers site · Apply there ↗

Elevance Health

This is a field-based care coordination role supporting individuals with long-term services and supports needs across eastern Iowa. The position suits someone with a background in social work or healthcare administration who can conduct assessments, develop care plans, and serve as a clinical liaison between members and their support networks.

Listed on Elevance Health’s careers site · Apply there ↗