- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration: 13 weeks Shift: ... - 16:30 Experience: Minimum of 2 years in Case Management License: Registered Nurse License...discharge planning and utilize interqual criteria - Experience in utilization review and concurrent reviews Description: This position requires… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per ... Diem Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location Ventura and Santa Paula, CA Job Type… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually Location Ventura and Santa Paula, CA Job Type Full-Time… more
- Cognizant (Sacramento, CA)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (CA)
- …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- The County of Los Angeles (Los Angeles, CA)
- …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management… more
- Molina Healthcare (Los Angeles, CA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... * Assists in implementing health management , care management , utilization management , behavioral health...in good standing. **Preferred Qualifications** * LVN (Licensed vocational nurse ) or RN ( Registered Nurse )… more
- Centene Corporation (Sacramento, CA)
- …degree and 4+ years of related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...with all policies and standards **Candidates must have a Registered Nurse (RN) license for California and… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...experience* at the level of Los Angeles County classification Registered Nurse I**. -AND- 2. A license… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- Sharp HealthCare (San Diego, CA)
- …End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; ... or clinical experience in area of specialty. + California Registered Nurse (RN) - CA Board of...and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …For more information, refer to Required Documents below." The Emergency Department (ED) nurse is a professional Registered Nurse who provides high-quality, ... support for patients and families. Responsibilities The Emergency Department (ED) Registered Nurse (RN) is responsible for providing competent, evidence-based… more
- CVS Health (CA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Sutter Health (Roseville, CA)
- …Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...+ Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California Upon Hire **TYPICAL… more
- VNA Health (Santa Barbara, CA)
- …Shift Differentials + Schedule: 3 days/week, 12 hours/day Job Description: The Inpatient Registered Nurse provides hospice care and is skilled at assessing pain ... services, treatments, diagnostic and preventive procedures requiring the skills of a registered nurse according to in-patient facility protocols. + Attend and… more
- Molina Healthcare (Los Angeles, CA)
- …combination of relevant education and experience. * At least 1 year of health care management leadership experience. * Registered Nurse (RN). License must be ... professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term services and… more
- Sutter Health (Roseville, CA)
- …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 2 ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
