• Case Manager (RN) - Utilization…

    Prime Healthcare (Chino, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219949/case- manager -%28rn%29 utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
    Prime Healthcare (08/14/25)
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  • Case Manager (RN) - Utilization…

    Prime Healthcare (San Dimas, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
    Prime Healthcare (07/15/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Utilization Review RN...system. 9. Conduct concurrent and admission reviews of patient records to assess medical necessity and adherence to evidence-based… more
    Alameda Health System (08/22/25)
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  • LVN - Utilization Management - SRS…

    Sharp HealthCare (San Diego, CA)
    …**FTE** 0.8 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... days** **of in-person training.** **What You Will Do** To provide comprehensive utilization management and coordination of care for SRS Members. Ensure timely and… more
    Sharp HealthCare (08/29/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization…

    Sharp HealthCare (San Diego, CA)
    …Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager ... (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start… more
    Sharp HealthCare (08/02/25)
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  • Utilization Management Representative I

    Elevance Health (Walnut Creek, CA)
    ** Utilization Management Representative I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative I** is responsible for coordinating cases...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
    Elevance Health (08/20/25)
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  • Nurse Manager - Neonatal Intensive…

    City and County of San Francisco (San Francisco, CA)
    …eligible list. * Reopen for additional applications Under general supervision, the 2322 Nurse Manager (NICU) supervises the delivery and evaluation of nursing ... care and the care environment. The 2322 Nurse Manager (NICU) performs the following essential...when assigned to a specific program; + Reviews clinical records to ensure accuracy and comprehensiveness of documentation; +… more
    City and County of San Francisco (08/17/25)
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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 + ... the organizational structure of a unit which promotes effective and economic utilization of personnel and supplies; assures availability and operability of supplies… more
    Alameda Health System (08/08/25)
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  • Case Manager , Registered Nurse…

    CVS Health (Sacramento, CA)
    …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... position consists of working intensely as a telephonic case manager with patients and their care team for fully...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
    CVS Health (08/15/25)
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  • Case Manager , Registered Nurse

    Sutter Health (San Francisco, CA)
    …nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN-Registered Nurse of California (required) + CCM-Certified Case Manager (preferred) ... CPMC-California Pacific Med Center Van Ness **Position Overview:** The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and… more
    Sutter Health (08/16/25)
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