• Manager , Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning. + ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… more
    Stanford Health Care (02/22/25)
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  • Utilization Management

    UCLA Health (Los Angeles, CA)
    …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager more
    UCLA Health (03/04/25)
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  • Case Manager - Utilization

    Prime Healthcare (National City, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205657/case- manager utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
    Prime Healthcare (04/25/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …Participate in orientation of fresh staff as requested by the Manager of Utilization Management . 17. Maintains knowledge of current trends and changes in ... System Utilization Management SUM Utilization ...in the State of California Preferred Licenses/Certifications: Certified Case Manager (CCM) or Accredited Case Manager (ACM)… more
    Alameda Health System (05/06/25)
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  • Supervisor, Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Knowledge of state, federal and regulatory requirements in Care/Case/ Utilization Management . Strong verbal and written communication skills. Computer ... Supervisor, Utilization Management RN Job Category: Clinical...Care's culturally diverse membership. The position supports the UM Manager /Director. This role also assists UM Educator/ Manager /Director… more
    LA Care Health Plan (04/11/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    … of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health ... Utilization Management Nurse Specialist RN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (03/27/25)
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  • Medical Director, UM - Utilization

    Rady Children's Hospital San Diego (San Diego, CA)
    …of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the clinical ... care and quality. The ideal candidate will have a strong pediatric clinical background. Utilization management experience is a plus. This position is part time… more
    Rady Children's Hospital San Diego (05/03/25)
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  • Case Manager , RN - Utilization

    Prime Healthcare (Lynwood, CA)
    …year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS (AHA) certificate, preferred.5. Knowledge of Milliman ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/case- manager %2c-rn utilization -review/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Francis Medical… more
    Prime Healthcare (04/17/25)
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  • Discharge Planner - Utilization

    Prime Healthcare (Chino, CA)
    …Discharge Plan. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205766/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityChino Valley Medical Center… more
    Prime Healthcare (04/28/25)
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  • LVN Care Coordinator - Utilization

    Sharp HealthCare (San Diego, CA)
    …care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
    Sharp HealthCare (05/04/25)
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