• Alameda Health System (San Leandro, CA)
    …background. Within the last 3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan. Required ... Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The… more
    DirectEmployers Association (10/15/25)
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  • Molina Healthcare (San Mateo, CA)
    …for gaps in care and preventive assessments. * Addresses both chronic and acute primary care complaints, and demonstrates ability to ascertain medical urgency. * ... of care. * Schedules appointments for visits when appropriate. * Provides post -discharge coordination to reduce hospital readmission rates and emergency room … more
    Appcast IO CPC (10/27/25)
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  • Molina Healthcare (Palm Springs, CA)
    …exams for gaps in care and preventative assessments Address both chronic and acute primary care complaints, and able to ascertain medical urgency Establish and ... plan of care Schedule patient appointments for visits when appropriate Provide post discharge coordination to reduce hospital readmission rates and emergency room … more
    Appcast IO CPC (10/27/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...will also be responsible for complying with AB 1203, Post Stabilization notification. AGENCY/DEPARTMENT: Health Care Agency - Ventura… more
    Ventura County (09/21/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89...evaluation of patient care data in order to coordinate post -discharge needs of patients. The Per Diem Nurse is… more
    Ventura County (09/27/25)
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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    …in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests where determination requires extended ... Utilization Management Admissions Liaison RN II...Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/ post -stabilization admission… more
    LA Care Health Plan (10/03/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …Experience: Three years of utilization review experience. Health insurance company and/or acute care hospital, post - acute and psych; three years of ... Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 +… more
    Alameda Health System (08/08/25)
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  • Utilization Management Clinical…

    CVS Health (Sacramento, CA)
    …+ Previous experience with prior authorization. + Previous experience with utilization management . + Previous experience in an acute care setting. + Previous ... with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior...care/treatment. + Identifies members who may benefit from care management programs or other post discharge programs… more
    CVS Health (10/26/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and … more
    Prime Healthcare (10/18/25)
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  • Case Manager (RN ) - Utilization

    Prime Healthcare (Montclair, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/230024/case-manager-%28rn-%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Overview Montclair Hospital Medical Center is a 106-bed acute care, not-for-profit community hospital, received the "100 Top Hospital" in the nation award from IBM… more
    Prime Healthcare (10/24/25)
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