• 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 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (10/03/25)
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  • RN Utilization Review Part- time Day

    Providence (Mission Hills, CA)
    … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... empower them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Experience working in a… more
    Providence (10/01/25)
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  • LCSW/LMFT - Orange County

    Amergis (Orange, CA)
    …Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and ... California unrestricted license such as LCSW, LPCC, LMFT or RN and related required education PLUS 3 years of...listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care… more
    Amergis (08/14/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization…

    Sharp HealthCare (San Diego, CA)
    …Degree; California Registered Nurse ( RN ) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... or clinical experience in area of specialty. + California Registered Nurse ( RN ) - CA...and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for… more
    Sharp HealthCare (08/02/25)
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  • Per Diem RN - Case Management…

    Sharp HealthCare (La Mesa, CA)
    …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... experience or case management experience. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
    Sharp HealthCare (09/06/25)
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  • RN Case Manager - Health Services…

    Sharp HealthCare (San Diego, CA)
    …**FTE** 1 **Shift Start Time** **Shift End Time** Other; Bachelor's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... is responsible for performing effective acute and ambulatory case management , utilization management and claims...+ 2 Years Medical or surgical nursing + California Registered Nurse ( RN ) - CA… more
    Sharp HealthCare (09/21/25)
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  • Nurse Supervisor, Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    …and in good standing. **Preferred Qualifications** * LVN (Licensed vocational nurse ) or RN ( Registered Nurse ) . License must be current, active and ... in some or all of the following functions: 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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  • RN Case Manager

    HCA Healthcare (Thousand Oaks, CA)
    …for our RN Case Manager opportunity. **Job Summary and Qualifications** The Registered Nurse ( RN ) Case Manager is responsible for promoting ... from any other healthcare provider. We are seeking an RN Case Manager to join our healthcare...Diploma required. BSN preferred. + Currently licensed as a Registered Nurse in the state of California… more
    HCA Healthcare (09/25/25)
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  • RN Case Manager - Case…

    Cedars-Sinai (CA)
    …named us one of America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from ... timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for identified...like family. **Req ID** : 10481 **Working Title** : RN Case Manager - Case Management… more
    Cedars-Sinai (09/29/25)
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  • Case Manager (CM) - RN or LCSW - FT…

    Select Medical (Los Angeles, CA)
    …/ Los Angeles, CA Case Manager (CM) - Full Time (on-site) - 8 hr shifts Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
    Select Medical (08/23/25)
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