• Enhanced Care Management (ECM) Program…

    Illumination Foundation (Stanton, CA)
    …Role The Program Coordinator is an administrator role dedicated to upkeep, management , and oversight of front-end and back-end programmatic processes. These include ... will also be centrally involved in communicating information to management and lead housing entities and will be relied...Health Network Portals and internal HER/AICA. + Upon referral review , note all questions that may need to be… more
    Illumination Foundation (09/20/25)
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  • Predictive Data Analyst / Emergency Appointment…

    The County of Los Angeles (Los Angeles, CA)
    …predictive and prescriptive analytics, to support data-driven program design and management ; and produces dashboards, reports, and other advanced data visualization ... under the immediate supervision of a Data Scientist Supervisor, or supervisor or manager responsible for the data analytics, research, or statistical function of a… more
    The County of Los Angeles (09/13/25)
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  • Senior Mental Health Nurse

    Ventura County (Ventura, CA)
    …evaluation, and review ; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with guidelines and standards ... The ideal candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of… more
    Ventura County (09/26/25)
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  • Cost Containment Analyst

    ICW Group (Sacramento, CA)
    …and trending of cost management issues related to bill review , case management and utilization review . + Works closely with Case Management ... with Cost Management Manager in tracking, resolution gathering,...Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review , Telephonic Nurse Case Management more
    ICW Group (09/22/25)
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  • RN Care Coordinator

    Dignity Health (Los Angeles, CA)
    …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management more
    Dignity Health (10/04/25)
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  • RN Care Coordinator

    Dignity Health (Long Beach, CA)
    …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management more
    Dignity Health (10/01/25)
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  • RN Care Coordinator

    Dignity Health (Long Beach, CA)
    …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management more
    Dignity Health (09/22/25)
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  • RN Care Coordinator

    Dignity Health (Glendale, CA)
    …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management more
    Dignity Health (09/19/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA,...(30%) Assist in the technical aspects of the retrospective review process for authorizations and Member or Provider Appeals,… more
    LA Care Health Plan (08/29/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Sacramento, CA)
    …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...**Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management more
    Highmark Health (10/10/25)
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