• Health Care Financial Analyst/Community…

    The County of Los Angeles (Los Angeles, CA)
    HEALTH CARE FINANCIAL ANALYST/COMMUNITY PROGRAMS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4827547) Apply  HEALTH CARE FINANCIAL ... of Diversion and Reentry seek qualified candidates to fill emergency Health Care Financial Analyst Community Programs vacancies related to the homelessness crisis.… more
    The County of Los Angeles (07/27/25)
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  • Translation Services Specialist III

    LA Care Health Plan (Los Angeles, CA)
    Translation Services Specialist III Job Category: Clinical Department: Cultural & Linguistic Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of… more
    LA Care Health Plan (08/08/25)
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  • RN Case Manager

    Lompoc Valley Medical Center (Lompoc, CA)
    …Bachelors in nursing degree preferred. + Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. ... and providing guidance to all District staff and physicians in the area of utilization of resources, appropriate level of care , and identification and reporting… more
    Lompoc Valley Medical Center (07/28/25)
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  • Assistant Nursing Director, Administration

    The County of Los Angeles (Los Angeles, CA)
    …+ Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: *In ... of community partner clinics - DHS annually provides direct care for 600,000 unique patients, employs over 23,000 staff,...of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical… more
    The County of Los Angeles (07/19/25)
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  • Senior Pharmacist

    Highmark Health (Sacramento, CA)
    …partners and stakeholders across the organization. Key responsibilities will include clinical review , assisting in navigating a complex regulatory environment, ... utilization management programs, and disease management initiatives. + Provide clinical review and decisions including but not limited to: physician… more
    Highmark Health (06/26/25)
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  • Medical Director- South Central

    Humana (Sacramento, CA)
    …insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical ...region or line of business. The Medical Director conducts Utilization Management of the care received by… more
    Humana (07/11/25)
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  • Sr. Sustainability Manager - Medical Integration

    Stanford Health Care (Menlo Park, CA)
    utilization methods to identify and implement innovations in patient care and/or participating in research, clinical investigatory or quality projects ... (United States of America) **This is a Stanford Health Care job.** At Stanford Medicine Health Care ,...for sustainability initiatives aimed at reducing environmental impacts in clinical settings. You'll manage projects that align with best… more
    Stanford Health Care (07/12/25)
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  • CDI Physician Advisor

    Sutter Health (Emeryville, CA)
    …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care , and observation status. Some ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA...compliance and accurate coding. The Physician Advisor (PA) conducts clinical reviews on cases referred by UM/CM staff and… more
    Sutter Health (08/02/25)
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  • Manager Care Coordination Social Work

    Dignity Health (Merced, CA)
    …+ Oversees the department in an efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work ... sign-on bonus not to exceed 10% of salary for this position. **Manager of Care Coordination (Case Management) Social Work** **Position Summary:** As our Manager of … more
    Dignity Health (07/17/25)
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  • Medical Director, MSK Surgery

    Evolent (Sacramento, CA)
    …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical… more
    Evolent (05/20/25)
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