• Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens ... leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and … more
    Prime Healthcare (07/18/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization

    Sharp HealthCare (San Diego, CA)
    …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
    Sharp HealthCare (08/02/25)
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  • Utilization Management

    Elevance Health (Walnut Creek, CA)
    ** Utilization Management Representative I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
    Elevance Health (08/20/25)
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  • Case Manager (RN) - Utilization

    Prime Healthcare (Chino, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/219949/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
    Prime Healthcare (08/14/25)
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  • Case Manager (RN) - Utilization

    Prime Healthcare (San Dimas, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
    Prime Healthcare (07/15/25)
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  • Care Manager RN - Utilization Review *Full…

    Providence (Napa, CA)
    …+ Upon hire: California Registered Nurse License + 2 years Case management , discharge planning, or utilization management experience in the acute, ... the utilization of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease Case Management more
    Providence (08/08/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Sacramento, CA)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
    Centene Corporation (08/09/25)
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  • LVN - Quality Assurance/ Utilization Review…

    Emanate Health (Covina, CA)
    …Education Requirement:** **Minimum Experience Requirement:** Minimum of three years of utilization management experience. Experience in quality- related job ... and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying… more
    Emanate Health (07/23/25)
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  • Nurse , Care Management

    Alameda Health System (Oakland, CA)
    Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The ... Nurse , Care Management + Oakland, CA... Nurse , Care Management + Oakland, CA + Highland General Hospital...background. Within the last 3 years, experience in Case Management in an acute setting or utilization more
    Alameda Health System (08/23/25)
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  • Nurse Practitioner - Pain Management

    ERP International (Camp Pendleton, CA)
    **Overview** ERP International, LLC is seeking a ** Nurse Practitioner** for a full-time position supporting the **Pain Management Clinic** at **Camp Pendleton, ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (06/04/25)
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