• Utilization Management Nurse

    CenterWell (Sacramento, CA)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Sacramento, CA)
    …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
    CenterWell (08/02/25)
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  • Care Manager RN - Utilization Review…

    Providence (Napa, CA)
    **Description** Care Manager RN - Utilization Review unit at Providence Queen of the Valley Medical Center in Napa, CA. This position is Full-Time and will work ... families throughout the continuum of care. The RN Case Manager assists patients in the utilization of...outpatient case management setting + Upon hire: California Registered Nurse License + 2 years Case management, discharge planning,… more
    Providence (08/08/25)
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  • Case Manager , RN - Utilization

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219588/case- manager %2c-rn utilization ... post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 years post… more
    Prime Healthcare (08/08/25)
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  • Case Manager (RN) - Utilization

    Prime Healthcare (San Dimas, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization ... post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 years post… more
    Prime Healthcare (07/15/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Utilization Review RN...Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California Preferred Licenses/Certifications: Certified… more
    Alameda Health System (07/29/25)
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  • Supervisor, Utilization Management RN

    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: Full Time ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of… more
    LA Care Health Plan (07/08/25)
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  • Utilization Management Admissions Liaison…

    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 Position Type: ... the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
    LA Care Health Plan (08/02/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization

    Sharp HealthCare (San Diego, CA)
    …Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager ... (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start… more
    Sharp HealthCare (08/02/25)
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  • Utilization Review RN

    Prime Healthcare (Ontario, CA)
    …of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of experience ... in utilization review, referrals, authorizations, denials and appeals. + Current BCLS (AHA) certificate upon hire and maintain current. + Knowledge of MCG Criteria… more
    Prime Healthcare (08/08/25)
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