• Case Manager, Registered Nurse - Fully Remote

    CVS Health (Sacramento, CA)
    At CVS Health , we're building a world of health ...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.**… more
    CVS Health (08/15/25)
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  • Telehealth Vocational Nurse

    Veterans Affairs, Veterans Health Administration (Ukiah, CA)
    …store-and-forward) palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to determine ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
    Veterans Affairs, Veterans Health Administration (05/30/25)
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  • Eureka Intermittent LVN/LPN

    Veterans Affairs, Veterans Health Administration (Eureka, CA)
    …Learn more Duties and responsibilities of the LVN/LPN include: Performs retrospective medical review of non-VA health care records to determine medical necessity ... are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. EDRP… more
    Veterans Affairs, Veterans Health Administration (08/14/25)
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  • RN Case Manager - Inpatient General Medicine Float

    UCLA Health (Santa Monica, CA)
    …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... able to make a significant, positive difference in someone's life. At UCLA Health , you'll experience this joy every day while also enjoying the positive, supportive,… more
    UCLA Health (08/08/25)
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  • Patient Logistics RN

    CommonSpirit Health (Rancho Cordova, CA)
    …The Patient Logistics RN supervises the transfer center activities for Dignity Health Facilities. The position functions as the supervisor during their assigned ... performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Core Duties:** + Compiles data… more
    CommonSpirit Health (07/28/25)
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  • LVN - Per Diem

    Hospice Of San Joaquin (Stockton, CA)
    …about the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... of care, under the supervision of the Director of Home Care Services and the direction of the RN... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration.… more
    Hospice Of San Joaquin (08/14/25)
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  • Physician, Chief of Inpatient Medicine

    Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
    …Angeles and Orange Counties, it does provide a small town setting for your home , work or recreation. Adjacent to California's Interstate 10 freeway, Loma Linda is ... to beaches, mountains and desert resorts. At VA Loma Linda Healthcare System, our health care teams are deeply experienced and guided by the needs of Veterans, their… more
    Veterans Affairs, Veterans Health Administration (06/15/25)
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  • Clinic Physician

    Dignity Health (Arnold, CA)
    …policies/procedures covering the services provided; participate in annual review of patient health records and utilization review studies of the Clinic ... healthcare services for patients and families, focusing on wellness and health promotion. This position requires the full understanding and active participation… more
    Dignity Health (06/25/25)
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  • State Supervisor - Orange County and Inland Empire…

    BrightSpring Health Services (Anaheim, CA)
    Our Company SpringHealth Behavioral Health and Integrated Care Overview If you're a BCBA in the state of California, and are looking for a leadership role, WE WANT ... Functional Behavior Assessments/Behavior Support Plans prior to implementation + Conduct home /community visits and consumer supervision as needed + Ensure all FBAs… more
    BrightSpring Health Services (08/08/25)
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  • Senior Clinical Policy Research Professional

    Humana (Sacramento, CA)
    …develop and maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is seeking ... and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy… more
    Humana (08/15/25)
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