• RN, Manager , Utilization…

    Humana (Sacramento, CA)
    **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
    Humana (09/28/25)
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  • Case Manager - Utilization…

    Prime Healthcare (Anaheim, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... in case management , discharge planning or nursing management ; 2. Experience and knowledge in basic...5 years of acute care experience preferred.2. Certified Case Manager (CCM) certification preferred.3. At least one-year experience in… more
    Prime Healthcare (08/08/25)
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  • Case Manager (RN) - Utilization…

    Prime Healthcare (Chino, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226811/case- manager -%28rn%29 utilization - ... year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS (AHA) certificate, preferred.5. Knowledge of Milliman… more
    Prime Healthcare (09/30/25)
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  • Case Manager - Utilization…

    Prime Healthcare (Montclair, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... or management , preferred. + Current BCLS certificate preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Montclair… more
    Prime Healthcare (09/30/25)
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  • Utilization Management Rn

    Actalent (Santa Barbara, CA)
    …centers - Jack heling hand, alpha resource center, parents helping parents, etc. knowledge of Utilization Management process/ turnaround times. + Familiar ... unit, such as Mental/Behavioral Health services. Skills: Care plans, Case Manager , Pediatrics, Utilization Management , Clinical Reviews Experience… more
    Actalent (10/01/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization…

    Sharp HealthCare (San Diego, CA)
    …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
    Sharp HealthCare (08/02/25)
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  • Nurse Supervisor, Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... * Assists in implementing health management , care management , utilization management , behavioral health...unrestricted in the state of California. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more
    Molina Healthcare (09/25/25)
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  • Discharge Planner - Utilization…

    Prime Healthcare (National City, CA)
    …Discharge Plan. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/224837/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityParadise… more
    Prime Healthcare (09/10/25)
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  • RN Utilization Review Part- time Day

    Providence (Mission Hills, CA)
    …health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, ... and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing… more
    Providence (10/01/25)
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  • Case Manager I - Sharp Memorial Hospital…

    Sharp HealthCare (San Diego, CA)
    …and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as specified ... policy.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
    Sharp HealthCare (07/13/25)
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