• Utilization Review Nurse…

    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 ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse…

    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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (06/28/25)
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  • LVN - Quality Assurance/ Utilization…

    Emanate Health (Covina, CA)
    …the United States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... 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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  • Utilization Management Nurse…

    CVS Health (Sacramento, CA)
    …(RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active and ... a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language… more
    CVS Health (08/15/25)
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  • Licensed Vocational Nurse , Licensed…

    Sutter Health (Sacramento, CA)
    …Health! **Organization:** SCP-Sutter Center for Psychiatry **Position Overview:** The Utilization Review /Discharge Planner (UR/DP) performs chart review ... a minimum of direction. + Critical thinking skills necessary to provide utilization review /discharge planning services appropriate to patients with complex… more
    Sutter Health (08/27/25)
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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...risk and/or patient safety which are identified during case review or other activities; + Reviews, analyzes and identifies… more
    Ventura County (08/10/25)
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  • Utilization Management Nurse…

    CVS Health (Sacramento, CA)
    …UM ( utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety clinical experience ... a high-volume clinical call center environment. + 1 year of varied UM ( utilization management) experience within an inpatient, concurrent review or prior… more
    CVS Health (08/15/25)
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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 Management Nurse

    CenterWell (Sacramento, CA)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… 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 ... Schedule:** Full time **Job Shift:** Day **Career Track:** Nursing **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas St **Work… more
    Providence (08/08/25)
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