• 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 ... (BSN) degree required + Five or more years of utilization management required + Four or more...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager more
    UCLA Health (12/30/25)
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  • Case Manager - Utilization

    Prime Healthcare (Sherman Oaks, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization - management ... Healthcare Workers Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost… more
    Prime Healthcare (12/30/25)
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  • RN - Case Manager - BSN -…

    John Muir Health (Walnut Creek, CA)
    …the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** + ... manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager ...Support - American Heart AssociationRequired + ACM Accredited Case Manager - ACMA American Case Management Association… more
    John Muir Health (12/27/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (12/20/25)
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  • RN Case Manager - Utilization Review

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization ... to compassion, quality, and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
    Prime Healthcare (12/19/25)
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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 (10/31/25)
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  • Discharge Planner - Utilization

    Prime Healthcare (Montclair, CA)
    …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/221097/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMontclair… more
    Prime Healthcare (12/30/25)
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  • Utilization Management

    Elevance Health (Costa Mesa, CA)
    ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/19/25)
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  • Behavioral Health Care Manager I

    Elevance Health (Costa Mesa, CA)
    …I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
    Elevance Health (12/31/25)
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  • RN Utilization Review - Full-time Days…

    Providence (Irvine, CA)
    …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...UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree Nursing. + Master's… more
    Providence (01/01/26)
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