- Providence (Napa, CA)
- **Description** Care Manager RN - Utilization Review unit at Providence Queen of the Valley Medical Center in Napa, CA. This position is Full-Time and will ... the utilization of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease Case Management … more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - ... 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN...in orientation of fresh staff as requested by the Manager of Utilization Management . 17.… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219588/case- manager %2c-rn utilization - ... Text: ### Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
- Prime Healthcare (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization - ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Proficient in application of clinical guidelines ... **Responsibilities** Responsible for the review of medical records for appropriate admission status...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- 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
- Actalent (Redlands, CA)
- Job Title: Remote LVN Case Manager - Utilization Management Job Description Join our dynamic Utilization Management team as an LVN Case Manager ... internal staff to ensure seamless care coordination. Essential Skills + Utilization review and management experience. + Familiarity with Medicare, MediCal,… more
- CenterWell (Sacramento, CA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Sacramento, CA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more