- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Sutter Health (Modesto, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon...management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …members and visitors. Position Qualifications: + Education: Current California license as Registered Nurse . Bachelors in nursing degree preferred. + Experience: ... A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. + Per Diem Positions: Case Management experience with a… more
- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San Leandro Hospital + SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req ... + FTE:0.7 + Posted:August 6, 2025 **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing comprehensive case management services to… more
- Cedars-Sinai (Marina Del Rey, 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 ... the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for… more
- Alameda Health System (San Leandro, CA)
- …+ FTE:0.01 + Posted:July 22, 2025 **Summary** **Job Summary:** The SLH Case Manager RN is responsible for providing comprehensive case management services to ... preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or… more
- Dignity Health (Rancho Cordova, CA)
- …of nursing. - BS degree or experience equivalent required. - Clear and current CA Registered Nurse ( RN ) license. - Knowledge of all applicable federal and ... required. - 3 years Utilization experience required in health plan/UM operations, Acute or subacute utilization review . - Graduate of an accredited school… more
- CenterWell (Sacramento, CA)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain… more
- CenterWell (Sacramento, CA)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more