• Clinical Reviewer, Nurse

    Evolent (Sacramento, CA)
    …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of the office of the Chief Medical… more
    Evolent (11/20/25)
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  • Nurse Informaticist IV

    Sutter Health (Sacramento, CA)
    …Responsible for validating and redesigning work flow and clinical content review for all clinical areas. Develops and maintains interdisciplinary teams to ... Health's clinical information systems. Provides focused attention and direction in the utilization of data from clinical information systems to develop metrics to… more
    Sutter Health (10/26/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Bellflower, CA)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (10/23/25)
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  • Medical Review Coordinator

    Prime Healthcare (Inglewood, CA)
    …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+ year of… more
    Prime Healthcare (11/05/25)
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  • Medical Review Coordinator

    Prime Healthcare (Ontario, CA)
    …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... a Health and Human Services field is highly preferred.2. Utilization Review experience is highly preferred.3. Clinical...interpersonal skills to build effective partnering relationships with physicians, nurse staff , coding staff and… more
    Prime Healthcare (10/31/25)
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  • Assistant Nursing Director, Administration

    The County of Los Angeles (Los Angeles, CA)
    …work of staff , and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction ... work of staff , and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
    The County of Los Angeles (10/18/25)
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  • Case Manager I - Transition Planner - Sharp…

    Sharp HealthCare (San Diego, CA)
    …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
    Sharp HealthCare (11/09/25)
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  • Per Diem RN - Case Management - Sharp Grossmont…

    Sharp HealthCare (La Mesa, CA)
    …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
    Sharp HealthCare (09/06/25)
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  • Case Manager

    Stanford Health Care (Palo Alto, CA)
    …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all… more
    Stanford Health Care (11/11/25)
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  • Case Manager Float

    Stanford Health Care (Palo Alto, CA)
    …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
    Stanford Health Care (11/11/25)
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