• Associate Manager , Clinical Health…

    CVS Health (CA)
    …**Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and ... closely with functional area leadership team (department Associate Managers, Manager , and other key stakeholders such as Medical Directors,...a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of… more
    CVS Health (10/08/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... field or at least one year experience in case management , discharge planning or nursing management...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 - Utilization

    Prime Healthcare (Montclair, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... degree in a related field. At least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of… more
    Prime Healthcare (09/30/25)
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  • Utilization Management Rn

    Actalent (Santa Barbara, CA)
    …unit, such as Mental/Behavioral Health services. Skills: Care plans, Case Manager , Pediatrics, Utilization Management , Clinical Reviews Experience ... Remote Utilization Management RN Leading healthcare facility...Remote Utilization Management RN Leading healthcare facility that aims to...need is now looking for a REMOTE Health Plan Nurse Coordinator to join their team! Here you will… more
    Actalent (10/01/25)
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  • Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… more
    LA Care Health Plan (07/16/25)
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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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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
    LA Care Health Plan (10/03/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization

    Sharp HealthCare (San Diego, CA)
    …; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing ; Certified Case Manager (CCM) - Commission for Case Manager ... 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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  • RN Utilization Review Part- time Day

    Providence (Mission Hills, 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...we must empower them. **Required Qualifications:** + Associate's Degree Nursing . + Upon hire: California Registered Nurse more
    Providence (10/07/25)
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  • Utilization Management

    Elevance Health (Cerritos, CA)
    ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time in **CALIFORNIA** , with the ... shift between 8 am - 5 pm PST. The ** Utilization Management Representative II** is responsible for...providers. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
    Elevance Health (10/02/25)
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