• Registered Nurse ( RN…

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
    LA Care Health Plan (12/09/25)
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  • Appeals Nurse

    Evolent (Sacramento, CA)
    …as an RN - **Required** + Minimum of 5 years in Utilization Management , health care Appeals , compliance and/or grievances/complaints in a quality ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Doing:** + Practices and maintains the principles of utilization management and appeals management by… more
    Evolent (12/24/25)
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  • Lead Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:... appeals and grievances experience in a managed care , utilization management and/or case management… more
    LA Care Health Plan (11/11/25)
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  • Supervising Registered Nurse D/CF

    Sacramento County (Sacramento, CA)
    Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply  Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… more
    Sacramento County (10/21/25)
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  • Registered Nurse Care…

    Cedars-Sinai (CA)
    …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour ... Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management ...nursing (Medical Surgical/Tele/ICU) with 2 or more year of care management experience (UM or DC Planning).… more
    Cedars-Sinai (01/01/26)
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  • Director, Home Health Grievances & Appeals

    CenterWell (Sacramento, CA)
    …of our caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and review process to preserve and ... level of clinical and regulatory integrity and compliance. Manages the Denials Management data analytics, denial and appeal process. The Director, Home Health… more
    CenterWell (01/08/26)
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  • Per Diem RN - Case Management…

    Sharp HealthCare (La Mesa, CA)
    …**Required Qualifications** + 3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...Cerner), and case management software (eg, Allscripts Care Management ).The RN CM will… more
    Sharp HealthCare (12/06/25)
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  • RN Case Manager - Care Coordination…

    University of Southern California (Arcadia, CA)
    …and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The Case ... of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as… more
    University of Southern California (11/19/25)
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  • Supervising Public Health Nurse *Revised

    Sacramento County (Sacramento, CA)
    …of Supervising Public Health Nurse : + Must possess and maintain a current Registered Nurse License and Public Health Nurse Certificate issued by the ... , growth, and development, including common illnesses + Case management techniques and the care and treatment...to this class must possess and maintain a current Registered Nurse license and Public Health … more
    Sacramento County (10/21/25)
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  • Case Manager II - Transition Planning - Sharp…

    Sharp HealthCare (San Diego, CA)
    …3 Years case management , utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...as defined by the CBA. + 3 Years acute care nursing experience or case management experience.… more
    Sharp HealthCare (12/18/25)
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