• Managed Care Case Manager Nurse II

    Sutter Health (Goleta, CA)
    …Nursing** + Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case ... management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Working knowledge of… more
    Sutter Health (07/25/25)
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  • Clinical Health Services Associate Manager

    CVS Health (Sacramento, CA)
    …in state of residence + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS ... team is producing at a successful level. The Associate Manager is also responsible for oversight of utilization...other key business areas. + May develop/assist in development and/ review new training content. + May collaborate/deliver inter and… more
    CVS Health (08/08/25)
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  • Care Manager , Health Plan, Part Time,…

    Magellan Health Services (San Diego, CA)
    …Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care...this role with necessary degrees, LMSW, LCSW, LPC, or RN . Minimum 5 years experience post degree in healthcare,… more
    Magellan Health Services (07/23/25)
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  • Manager of ICU Critical Care

    HCA Healthcare (Thousand Oaks, CA)
    Manager of Critical Care role today!** **Job Summary and Qualifications** The Clinical Nursing Manager is a registered nurse who reports directly to the ... and the United Kingdom. We are looking for a Manager of Critical Care for our Los Robles Regional...of nursing; BSN desired, MSN preferred. + Current California Registered Nurse License. + Current BCLS and… more
    HCA Healthcare (07/30/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... + 2 Years Medical Management experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA Board of Registered Nursing… more
    Sharp HealthCare (07/09/25)
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  • Enhanced Care Management Clinical Specialist II

    LA Care Health Plan (Los Angeles, CA)
    …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training Physical Requirements… more
    LA Care Health Plan (07/16/25)
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  • Strategic Clinical Quality Manager

    Fresenius Medical Center (Rancho Cucamonga, CA)
    …related field preferred or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality ... barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders,… more
    Fresenius Medical Center (07/15/25)
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  • Medical Management Clinician Senior 100% Virtual

    Elevance Health (CA)
    …on relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior clinicians. **How you will ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
    Elevance Health (06/06/25)
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  • Nursing Manager Care Coordination

    Dignity Health (Carmichael, CA)
    **Responsibilities** ** Nurse Manager of Care Coordination / Case Management** **Sign On / Relocation Options** As our ** Nurse Manager Care Coordination ... efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality… more
    Dignity Health (07/10/25)
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  • Primary Care Physician (PCP)

    STG International (Corona, CA)
    …*Assist in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's ... patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health… more
    STG International (06/18/25)
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