• Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
    The County of Los Angeles (06/28/25)
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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 Needed / Per ... Req #:42003-31126 + FTE:0.01 + Posted:August 21, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible… more
    Alameda Health System (08/22/25)
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  • Utilization Review Tech II

    Prime Healthcare (Ontario, CA)
    …is actively seeking new members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization ... and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry, mailing/faxing… more
    Prime Healthcare (08/23/25)
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  • Utilization Review Technician III

    Prime Healthcare (Ontario, CA)
    …is actively seeking new members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization ... plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while working closely with… more
    Prime Healthcare (08/23/25)
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  • Utilization Review , Management…

    Sutter Health (Sacramento, CA)
    …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... meeting the organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop expertise on matters… more
    Sutter Health (08/28/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Sacramento, CA)
    …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
    Centene Corporation (08/09/25)
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  • LVN - Quality Assurance/ Utilization

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....support and review of medical claims and utilization practices. Complete medical necessity and level of care… more
    Emanate Health (07/23/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... utilization reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance with industry… more
    Alameda Health System (08/08/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    …Under direction, scheduled as needed to assist with patient care coordination and utilization review . The incumbent will be responsible to assist with evaluation ... Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem… more
    Ventura County (08/10/25)
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