• Case Manager I - Sharp Memorial Hospital - FT…

    Sharp HealthCare (San Diego, CA)
    …patient care areas. This position requires the ability to combine clinical /quality considerations with regulatory/financial/utilization review demands to assure ... advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers. Review all cases with readmission within… more
    Sharp HealthCare (10/11/25)
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  • Per Diem RN - Case Management - Sharp Grossmont…

    Sharp HealthCare (La Mesa, CA)
    …patient care areas. This position requires the ability to combine clinical /quality considerations with regulatory/financial/utilization review demands to assure ... advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers. Review all cases with readmission within… more
    Sharp HealthCare (09/06/25)
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  • RN Care Coordinator - Inpatient Specialty Program

    Cedars-Sinai (Beverly Hills, CA)
    …their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure ... Milliman and Interqual guidelines as necessary. + Collaborates with clinical teams and practices to ensure synchronization of sub-areas'...of care and level of care. Use evidence based review guidelines to conduct utilization review as… more
    Cedars-Sinai (10/12/25)
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  • SLH Case Manager RN

    Alameda Health System (San Leandro, CA)
    …Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or experience in ... other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed. + Encourages patients to develop realistic plans. Makes… more
    Alameda Health System (08/08/25)
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