• RN - UM / Medical

    Elevance Health (Walnut Creek, CA)
    RN - Utilization / Medical Management Nurse / InPatient (JR171072) **Work Hours** : 8 hour shift within 8am - 6pm PST. Rotating Weekends and holidays. ... 8am - 6pm PST. Rotating Weekends and holidays. The ** Medical Management Nurse ** is responsible...an equivalent background. + Current active, valid and **unrestricted RN license** to practice as a health professional within… more
    Elevance Health (10/22/25)
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  • Care Review Clinician ( RN ) Night Shift

    Molina Healthcare (San Francisco, CA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** * At least… more
    Molina Healthcare (08/24/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... Director, Utilization Management + Oakland, CA + Highland General Hospital...the utilization of healthcare services, including appropriateness, efficiency, and medical necessity of treatments and procedures. + Analyze data… more
    Alameda Health System (08/08/25)
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  • Manager, Care Management

    Sutter Health (Burlingame, CA)
    …for Social Work Candidates Only or equivalent education/experience **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California + CCM- Preferred + ... state regulations and guidelines. Has frequent contact with the Administrative Team, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary… more
    Sutter Health (10/22/25)
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