• 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 (05/22/25)
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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 + Full Time - Evening ... **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 (07/29/25)
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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 Review RN

    Prime Healthcare (Ontario, CA)
    …Post Graduate of an accredited school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/211752/ utilization - review - rn more
    Prime Healthcare (08/08/25)
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  • Utilization Review RN

    Dignity Health (Long Beach, CA)
    …+ AHA BLS + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Proficient in application of clinical guidelines ... **Responsibilities** Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the… more
    Dignity Health (08/10/25)
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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 - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
    Prime Healthcare (08/08/25)
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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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