• RN - Quality Assurance/ Utilization…

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....using clinical judgment and refer to Medical Directors for review depending on case findings. **Job Requirements**… more
    Emanate Health (09/06/25)
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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...the department head as indicated. + Utilization review and utilization managementThe RN … more
    Sharp HealthCare (09/06/25)
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  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... of Case Management to lead our dynamic Case Management Team consisting of Registered Nurses,...and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in… more
    Prime Healthcare (10/18/25)
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  • RN Case Manager

    Amergis (Sacramento, CA)
    Registered Nurse Case Manager - Utilization Management + Location: Sacramento, CA + Start Date: ASAP + Assignment Length: 13 Weeks + Openings: 1 + Weekly ... year of acute/inpatient case management experience + Prior utilization review experience required Certifications: + Active California RN License + Basic… more
    Amergis (11/08/25)
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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 ...like family. **Req ID** : 11088 **Working Title** : RN Case Manager - Case … more
    Cedars-Sinai (10/19/25)
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  • RN UR Case Manager Extra on Call

    Trinity Health (Fresno, CA)
    …through the effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse ( RN ) in the state of California is required. 2. ... **Employment Type:** Part time **Shift:** **Description:** This position coordinates utilization review service for defined patient populations across the acute… more
    Trinity Health (10/10/25)
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  • RN Case Manager - Care Coordination…

    University of Southern California (Arcadia, CA)
    …+ Assist in the compilation of physician profile data regarding LOS, resource utilization , denied days, cost, case mix index, patient satisfaction, and quality ... indicators including case mix, LOS, cost per case , excess days, resource utilization , readmission rates,...continuous improvement in both areas. + Perform 100% UR Review on all Medicare One-Day admissions. + Proactively identifies… more
    University of Southern California (11/19/25)
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  • Utilization Review Clinician (Santa…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …Per Hour RN /LCSW/LMFT/LPCC $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary ... both mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50… more
    Sacramento Behavioral Healthcare Hospital (10/24/25)
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  • Case Manager I - Transition Planner - Sharp…

    Sharp HealthCare (San Diego, CA)
    …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
    Sharp HealthCare (11/09/25)
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  • RN Case Manager, Per Diem

    UCLA Health (Los Angeles, 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 ... teams + Knowledge of a large university teaching hospitals Preferred: Strong Utilization Review and discharge planning experience and understanding of CMS… more
    UCLA Health (10/29/25)
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