• Director , Utilization Management

    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...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (08/08/25)
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  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team consisting ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patiens receive… more
    Prime Healthcare (08/26/25)
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  • Medical Director - National Medicare

    Humana (Sacramento, CA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
    Humana (08/21/25)
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  • Medical Director - NorthEast Region

    Humana (Sacramento, CA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
    Humana (07/25/25)
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  • Medical Director , Ventura County Health…

    Ventura County (Ventura, CA)
    …communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance ... Medical Director , Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113) Apply  Medical Director , Ventura… more
    Ventura County (08/04/25)
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  • Director Of Nursing / DON / 10k Sign On

    BrightSpring Health Services (Sacramento, CA)
    …of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure adequate ... with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the day-to-day clinical… more
    BrightSpring Health Services (08/16/25)
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  • Utilization Management Admissions Liaison…

    LA Care Health Plan (Los Angeles, CA)
    …admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires ... Utilization Management Admissions Liaison RN II Job Category:...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
    LA Care Health Plan (08/02/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …under the direction of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years Experience in ... Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management, or Quality Management certification preferred. **Essential… more
    Sharp HealthCare (07/09/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:… more
    LA Care Health Plan (08/26/25)
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  • Supervisor, Utilization Management RN

    LA Care Health Plan (Los Angeles, CA)
    Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of… more
    LA Care Health Plan (07/08/25)
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