• Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must... Utilization Review Nurse is an RN that has Case Management experience whose… more
    The County of Los Angeles (08/18/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As ... 21, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN ...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (08/22/25)
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  • Supervisor, Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (07/08/25)
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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (08/02/25)
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  • Case Manager ( RN ) - Utilization

    Prime Healthcare (Chino, CA)
    …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219949/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityChino… more
    Prime Healthcare (08/14/25)
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  • Case Manager ( RN ) - Utilization

    Prime Healthcare (San Dimas, CA)
    …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan… more
    Prime Healthcare (07/15/25)
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  • Managed Long Term Services and Supports…

    LA Care Health Plan (Los Angeles, CA)
    …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category:...and must adhere to regulatory mandates that apply to Utilization Management (UM) and Care Management more
    LA Care Health Plan (08/26/25)
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  • RN - Quality Assurance/ Utilization

    Emanate Health (Covina, CA)
    …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
    Emanate Health (07/23/25)
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  • Payment Integrity Nurse Coder RN III

    LA Care Health Plan (Los Angeles, CA)
    …of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Payment Integrity Nurse Coder RN III Job Category:...process through medical record review for Payment Integrity and Utilization Management projects. The position serves as… more
    LA Care Health Plan (08/23/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization

    Sharp HealthCare (San Diego, CA)
    …**Shift End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse ( RN ) - CA Board of Registered ... or clinical experience in area of specialty. + California Registered Nurse ( RN ) - CA...and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for… more
    Sharp HealthCare (08/02/25)
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