• CCHP Public Portal (San Francisco, CA)
    …Performs other duties as assigned by the Medical Director. Qualifications An active CA Registered Nurse license with a minimum of a Bachelor's degree or ... regulatory agencies as well as audits for several health plans for delegated UM functions and develops and monitors corrective action plans. Essential Duties and… more
    job goal (01/13/26)
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  • Ami Network (Pasadena, CA)
    …at this time. Requirements: Healthplan Experience + Medicare Advantage 3-5 years Management Experience RN in CA Daily audits of UM until they are in full ... you'll oversee 4 direct reports on the IPA side ( UM supervisors + coordinator), and play a crucial role...a crucial role in providing operational leadership to the UM /Prior Authorization and Inpatient Teams (50 FTEs in total).… more
    job goal (01/12/26)
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  • UM RN

    Dignity Health (Bakersfield, CA)
    …experience. - Graduate of an accredited RN Program. - Clear and current CA Registered Nurse ( RN ) license. - Knowledge of nursing theory and ability to ... **Job Summary and Responsibilities** As a Utilization Management RN , you will be crucial in ensuring accurate...line with CommonSpirit's values. You will function as a UM nurse reviewer, applying clinical expertise to… more
    Dignity Health (12/18/25)
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  • UM Prior Authorization Review Nurse

    UCLA Health (Los Angeles, CA)
    Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This ... clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and… more
    UCLA Health (01/01/26)
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  • Behavioral Health Care Manager II, UM

    Elevance Health (Cerritos, CA)
    **Behavioral Health Care Manager II, UM ** **Location:** California **Virtual:** This role enables associates to work virtually full-time, with the exception of ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...equivalent background. + Current active unrestricted license such as RN LCSW LMHC LPC LMFT or Clinical Psychologist to… more
    Elevance Health (01/07/26)
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  • Registered Nurse -Utilization Review…

    Cedars-Sinai (Los Angeles, CA)
    …one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management ( UM ) Registered Nurse - Medicare Short Stay & Concurrent Denials ... in accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity,...Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse -Utilization Review Case Manager -… more
    Cedars-Sinai (01/02/26)
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  • Registered Nurse - Case Manager

    ERP International (Twentynine Palms, CA)
    **Overview** ERP International is seeking ** Registered Nurse ( RN ) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more
    ERP International (11/20/25)
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  • Registered Nurse - Care Coordinator…

    Cedars-Sinai (CA)
    …why US News & World Report has named us one of America's Best Hospitals. As a Registered Nurse , Care Coordinator at Cedars-Sinai you will; + You will serve as a ... Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management preferred or...continued employment. **Req ID** : 14082 **Working Title** : Registered Nurse - Care Coordinator - 8… more
    Cedars-Sinai (01/02/26)
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  • Registered Nurse Care Coordinator-…

    Cedars-Sinai (CA)
    …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... + For patients who are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF's for continued review and… more
    Cedars-Sinai (01/01/26)
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  • Registered Nurse - Care Coordinator…

    Cedars-Sinai (CA)
    …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 12784 **Working Title** : Registered Nurse - Care Coordinator - 8 Hour Days **Department** : Case ... **Education:** + BSN required **License/Certification:** + Current, unrestricted California RN license + American Heart Association BLS + Case Management… more
    Cedars-Sinai (12/31/25)
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