• RN - Utilization Review

    Providence (Mission Hills, CA)
    **Description** RN - Utilization Review ...+ Associate's Degree in Nursing. + Upon hire: California Registered Nurse License + 2 years of ... is Remote (Working from Home 100%) and will work Part -Time, 8-hour Day shifts (20 hours per week). Successful... Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently… more
    Providence (05/30/25)
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  • Case Manager (CM) - Registered Nurse

    Select Medical (Los Angeles, CA)
    …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
    Select Medical (05/14/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (San Diego, CA)
    …while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans ... looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
    Fresenius Medical Center (05/08/25)
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  • Assessment & Referral Registered

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Assessment & Referral Registered Nurse PAY RANGE: $63.00-$78.00 per hour REPORTS TO: ... and procedures, ensuring compliance with regulations, standards and requirements. The Registered Nurse - Assessments & Referrals maintains knowledge,… more
    Sacramento Behavioral Healthcare Hospital (04/20/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Sacramento, CA)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • Care Manager, Registered Nurse

    Sutter Health (Roseville, CA)
    …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of… more
    Sutter Health (05/21/25)
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  • Case Manager II, Registered Nurse

    Sutter Health (Burlingame, CA)
    …: **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire CCM certification ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
    Sutter Health (05/07/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN more
    The County of Los Angeles (05/22/25)
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  • RN - Quality Assurance/ Utilization

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices.… more
    Emanate Health (04/23/25)
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  • Case Manager ( RN ) - Utilization

    Prime Healthcare (Montclair, CA)
    …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference....to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
    Prime Healthcare (05/28/25)
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  • Director Revenue Integrity & Clinical…

    Emanate Health (Covina, CA)
    …country. **J** **ob Summary** The Director of Revenue Integrity & Clinical Utilization Review provides clinical oversight and operational leadership for clinical ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen... utilization review , charge capture, and revenue integrity… more
    Emanate Health (05/23/25)
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  • SLH Case Manager RN , Part Time,…

    Alameda Health System (San Leandro, CA)
    …preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or ... Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. PayRange:$58.74- $97.91/… more
    Alameda Health System (05/06/25)
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  • Case Manager - SH ( RN ) - Inpatient Case…

    Stanford Health Care (Palo Alto, CA)
    …the processes and outcomes of patient health care **Licenses and Certifications** + Nursing / RN - Registered Nurse - State Licensure and/or Compact State ... If you're ready to be part of our legacy of hope and innovation,...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review more
    Stanford Health Care (05/20/25)
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  • RN Case Manager

    HCA Healthcare (Riverside, CA)
    …a balance of optimal care and appropriate resource utilization . Requirements: + Registered Nurse ( RN ) with current California license required, Case ... **Introduction** Do you have the career opportunities as an RN Case Manager you want in your current role?...Management Certification or utilization review preferred + Associate's Degree minimum… more
    HCA Healthcare (05/31/25)
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  • Research Nurse ( RN ), Oncology

    Stanford Health Care (Palo Alto, CA)
    …on-call. **A Brief Overview** The Oncology Research Nursing Professional (ORNP) -is a Registered Nurse ( RN ) who works collaboratively with Clinical Research ... Part of a Cohesive Team: Stanford Oncology Research Nurse Professionals work with a collaborative and supportive team...Practices training (can be completed after hire) + California Registered Nurse license + Basis Life Support… more
    Stanford Health Care (03/19/25)
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  • Case Manager (CM) - RN or LCSW - FT - $10k…

    Select Medical (Los Angeles, CA)
    …/ Los Angeles, CA Case Manager (CM) - Full Time (on-site) - 8 hr shifts Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Schedule: Mon - ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
    Select Medical (05/14/25)
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  • Manager, Care Coordination ( RN

    Stanford Health Care (Palo Alto, CA)
    …knowledge to create an effective plan to address them. **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact State ... If you're ready to be part of our legacy of hope and innovation,...Knowledge of principles and best practices of case management, utilization review , social work, care coordination and… more
    Stanford Health Care (04/16/25)
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  • Hospital Admitting RN - PT Varied Shifts…

    Guidehouse (Los Angeles, CA)
    …**Clearance Required** **:** None **What You Will Do** **:** The **Hospital Admitting Registered Nurse PART ** **TIME, varied shiftts** will facilitate ... of prior relevant experience, 2 of the years as RN + Graduation from an accredited school of nursing....Nice To Have** **:** + Two years' experience in utilization review with external payors within a… more
    Guidehouse (05/03/25)
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  • Care Coordinator RN

    Dignity Health (Santa Maria, CA)
    …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
    Dignity Health (05/25/25)
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  • RN Care Coordinator

    Dignity Health (Oxnard, CA)
    …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Must have critical thinking and problem-solving ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
    Dignity Health (04/26/25)
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