• Utilization Review RN

    Prime Healthcare (Ontario, CA)
    nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of experience ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/222731/ utilization -review-rn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
    Prime Healthcare (10/05/25)
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  • Clinical Nurse IV - (Assistant Nurse

    Alameda Health System (Oakland, CA)
    Clinical Nurse IV - (Assistant Nurse Manager ) - Labor & Delivery - (L&D) + Oakland, CA + Highland General Hospital + Labor and Delivery + Full Time - Night + ... Management + $73.81 to $103.78 per hour + Req...**SUMMARY** Under general supervision, directs the professional and support nursing personnel and provides individualized, goal-directed nursing more
    Alameda Health System (08/08/25)
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  • Case Manager , Registered Nurse

    Sutter Health (San Francisco, CA)
    … is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The RN ... has frequent contact with patients, families, physicians, the interdisciplinary team, nursing management , quality, ancillary services, third party payers and… more
    Sutter Health (08/16/25)
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  • Clinical Case Manager -Oncology…

    Sharp HealthCare (San Diego, CA)
    …American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing ; Certified Case Manager (CCM) - Commission for Case Manager ... and evaluation of health care promotion programs and/or community development. + California Registered Nurse (RN) - CA Board of Registered Nursing + AHA Basic… more
    Sharp HealthCare (09/20/25)
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  • Telephonic Nurse Case Manager

    ICW Group (San Diego, CA)
    …(RN) or Licensed Vocational Nurse (LVN) required. Certification in case management , rehabilitation nursing or a related specialty is strongly preferred. ... and evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical treatment… more
    ICW Group (09/17/25)
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  • Care Manager , Registered Nurse

    Sutter Health (Roseville, CA)
    …acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management , quality, ancillary services, third party payers… more
    Sutter Health (09/26/25)
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  • Case Manager , Registered Nurse

    CVS Health (CA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... position consists of working intensely as a telephonic case manager with patients and their care team for fully...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (10/02/25)
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  • Care Manager , Registered Nurse

    Sutter Health (Roseville, CA)
    …Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...accredited school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN-Registered Nurse more
    Sutter Health (09/26/25)
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  • Case Manager II, Registered Nurse

    Sutter Health (Burlingame, CA)
    …acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management , quality, ancillary services, third party payers… more
    Sutter Health (09/19/25)
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  • Senior Mental Health Nurse

    Ventura County (Ventura, CA)
    …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... CANDIDATE The ideal candidate is an experienced Mental Health Nurse with a background in utilization review...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
    Ventura County (09/26/25)
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