• Telephonic Nurse Case Manager II

    Elevance Health (Los Angeles, CA)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.**...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (08/29/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Sacramento, CA)
    …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
    Highmark Health (10/10/25)
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  • Registered Nurse - Clinical Documentation…

    Cedars-Sinai (Los Angeles, CA)
    …required Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of ... **Job Description** Are you ready to bring your advanced Health Information Management skills to a world-class facility recognized as one of the top ten in the… more
    Cedars-Sinai (09/18/25)
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  • Registered Nurse Case Manager - 5K Sign…

    VNA Health (Santa Barbara, CA)
    …a $5,000 sign on BONUS! Job Description: VNA Health is looking for compassionate Registered Nurse Case Managers (RN CM) to join our Home Health care team. The RN CM ... organizes and directs home care services. Responsibilities: + Responsible for continuous review of all aspects of every patient on his/her caseload to include:… more
    VNA Health (10/17/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Pasadena, 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 (10/01/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Newport Beach, 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 (09/19/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (San Bernardino, 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 loss review . * Responsible for all required network reporting and on-site state… more
    Fresenius Medical Center (08/09/25)
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  • Cost Containment Analyst

    ICW Group (Sacramento, CA)
    …Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review , Telephonic Nurse Case Management , and Field ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides oversight for all vended Nurse Case Management (NCM) products, including Field... issues related to bill review , case management and utilization review . +… more
    ICW Group (09/22/25)
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  • Nurse Supervisor Home Health

    Dignity Health (Rancho Cordova, CA)
    …Operations team with achieving and maintaining compliance with quality improvement, risk management , and utilization review strategies. **Skills for success ... \#homehealthmanager, **Job Requirements** **Minimum:** + Minimum of two (2) years of management /leadership experience (within the last 5 years) in a home health… more
    Dignity Health (10/03/25)
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  • Medical Claim Review LVN/LPN (CA LVN…

    Molina Healthcare (San Diego, CA)
    …**Required Experience** Minimum three years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required ... implementation of proactive approaches to improve and standardize overall retrospective claims review . * Ensures core system is updated correctly to process claim..… more
    Molina Healthcare (10/18/25)
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