- Prime Healthcare (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/ case -manager-%28rn%29 utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - ... 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN...Required Experience: Minimum three (3) years of experience in Utilization Management or Case … more
- 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 ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...the County of Los Angeles, a Utilization Review Nurse is an RN that has Case... Review Nurse is an RN that has Case Management experience whose primary charge is… more
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... A broad knowledge base of health care delivery and case management within a managed care environment....within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Providence (Napa, CA)
- … of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease Case Management based ... **Description** Care Manager RN - Utilization Review unit at Providence Queen...Upon hire: California Registered Nurse License + 2 years Case management , discharge planning, or utilization… more
- LA Care Health Plan (Los Angeles, CA)
- …in an acute hospital setting. Previous experience to have a strong understanding of Utilization Management / Case Management practices including, but not ... Utilization Management Admissions Liaison RN II...and determinations within required turnaround times specific to the case type. Identifies requests needing medical director review… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... Education Requirement:** **Minimum Experience Requirement:** Minimum of three years of utilization management experience. Experience in quality- related job… more
- Dignity Health (Bakersfield, CA)
- …+ Minimum two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. + Ability to ... pass annual Inter-rater reliability test for Utilization Review product(s) used. **Preferred** + Graduate...least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN),… more
- CVS Health (Sacramento, CA)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review...+ 1 year of varied UM ( utilization management ) experience within an inpatient, concurrent review … more
- Actalent (Redlands, CA)
- Job Title: Remote LVN Case Manager - Utilization Management Job Description Join our dynamic Utilization Management team as an LVN Case Manager ... appropriate contracts as necessary. + Identify cases requiring additional case management and coordinate care with relevant...staff to ensure seamless care coordination. Essential Skills + Utilization review and management experience.… more