• Director , Utilization…

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
    Alameda Health System (08/08/25)
    - Related Jobs

  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
    Prime Healthcare (08/26/25)
    - Related Jobs

  • Medical Director - Southeast Region

    Humana (Sacramento, CA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (09/10/25)
    - Related Jobs

  • Medical Director - Northeast Region

    Humana (Sacramento, CA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/25/25)
    - Related Jobs

  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
    LA Care Health Plan (09/10/25)
    - Related Jobs

  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
    Sharp HealthCare (07/09/25)
    - Related Jobs

  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
    LA Care Health Plan (09/09/25)
    - Related Jobs

  • Nursing Director , Administration…

    The County of Los Angeles (Los Angeles, CA)
    NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) Apply  NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Salary $163,996.80… more
    The County of Los Angeles (09/03/25)
    - Related Jobs

  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... + Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, site… more
    Sharp HealthCare (07/19/25)
    - Related Jobs

  • Director , Inpatient System Care…

    Alameda Health System (Oakland, CA)
    Director , Inpatient System Care Management + Oakland, CA + Highland General Hospital + SYS Care Coordination + Full Time - Varies + Management + Req ... Alameda Health System is hiring! Under the direction of the Vice President of Care Management , the Director of Inpatient System Care Management manages the… more
    Alameda Health System (08/08/25)
    - Related Jobs