• RN UR Case Manager Extra on Call

    Trinity Health (Fresno, CA)
    …effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse (RN) in the state of California is required. 2. Current American Heart ... Association (AHA) Healthcare Provider CPR card is preferred. 3. Degree from an accredited baccalaureate nursing program (BSN) is preferred. 4. Certified Case Manager (CCM) national certification is preferred. 5. Interquel training must be obtained within six… more
    Trinity Health (10/10/25)
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  • Clinical Case Manager - Sharp Mesa Vista Hospital…

    Sharp HealthCare (San Diego, CA)
    …and Family Therapist (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start ... Healthcare) - American Heart Association -REQUIRED + California Registered Nurse (RN) - CA Board of Registered Nursing **OR**...status and situation in order to make effective discharge plans. UR documentation in IDX is completed by end of… more
    Sharp HealthCare (11/12/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Sacramento, CA)
    …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...experience + 2 years Health Plan or Acute Care UR /CM + Preferred Experience: 5 years acute care or… more
    Datavant (11/12/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours** **:** ... experience, preferably in a managed care setting + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred Qualifications**… more
    Sharp HealthCare (10/07/25)
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  • Utilization Review Clinician - Behavioral Health

    Centene Corporation (San Diego, CA)
    …benefits including a fresh perspective on workplace flexibility. **Behavioral Health UR Clinical Call Center Environment - Coverage: 365/24 -7** **Required Days: ... or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: $26.50 -… more
    Centene Corporation (11/26/25)
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  • Utilization Review LVN

    Dignity Health (Rancho Cordova, CA)
    …the Greater Sacramento, CA region.** **Position Summary:** The Utilization Review ( UR ) LVN uses clinical judgement in providing utilization management (UM )services. ... - 5 years LVN experience. - Clear and current CA Licensed Vocational Nurse (LVN) license. - Knowledge of health plans. Medical specialty procedures and diagnoses.… more
    Dignity Health (11/21/25)
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  • Medical Review Coordinator

    Prime Healthcare (Inglewood, CA)
    …CMO (Chief Medical Officer). Actively participates in the Case management and UR meetings. Serves as on-going educator to all departments. Responsible for reviewing ... 5. Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff. 6. Ability to… more
    Prime Healthcare (11/05/25)
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