• Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… 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...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… 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 / ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (08/22/25)
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  • Care Manager RN - Utilization…

    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 ... or outpatient case management setting + Upon hire: California Registered Nurse License + 2 years Case...time **Job Shift:** Day **Career Track:** Nursing **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas… more
    Providence (08/08/25)
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  • RN - Quality Assurance/ Utilization…

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

    Centene Corporation (Sacramento, CA)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare… more
    Centene Corporation (08/09/25)
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  • Utilization Management Nurse…

    CVS Health (Sacramento, CA)
    …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to include initial and...of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience.… more
    CVS Health (08/15/25)
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  • Per Diem Registered Nurse II/III…

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

    Amergis (French Camp, CA)
    Salary: $3042 / Week The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of ... resources, service delivery, and compliance with medical regime. Minimum Requirements: + Current RN licensure in state practicing + At least one year of Case… more
    Amergis (08/22/25)
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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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