• Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization more
    Prime Healthcare (10/18/25)
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  • 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 ... and determinations within required turnaround times specific to the case type. Identifies requests needing medical director ...setting. Previous experience to have a strong understanding of Utilization Management / Case Management more
    LA Care Health Plan (10/03/25)
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  • Per Diem RN - Case Management

    Sharp HealthCare (La Mesa, CA)
    …performance planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... outcomes. **Required Qualifications** + 3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse (RN) - CA Board… more
    Sharp HealthCare (12/06/25)
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  • Senior Utilization Management

    Providence (Mission Hills, CA)
    …Answers and screens phones. Schedules and coordinates all meetings attended by Administrative Director of Managed Care, Contract Manager, Case Managers and UM ... ID:** 403694 **Company:** Providence Jobs **Job Category:** Health Information Management **Job Function:** Revenue Cycle **Job Schedule:** Full time **Job… more
    Providence (12/09/25)
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  • Medical Director - IP Claims…

    Humana (Sacramento, CA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants..., depending on the line of business. The Medical Director conducts Utilization Management or… more
    Humana (12/11/25)
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  • Case Manager I - Transition Planner - Sharp…

    Sharp HealthCare (San Diego, CA)
    …performance-planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; Master's Degree… more
    Sharp HealthCare (11/09/25)
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  • Medical Director - Medicaid N. Central

    Humana (Sacramento, CA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
    Humana (10/25/25)
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  • Case Manager, RN - Case

    University of Southern California (Los Angeles, CA)
    …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... Participates in InterQual competency testing as requested by department director . + Outcomes Management * Participates in...Qualifications: + Pref Bachelor's degree + Pref 1 year Case management or utilization review… more
    University of Southern California (11/19/25)
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  • RN Case Manager - Value Based Service Org…

    University of Southern California (Alhambra, CA)
    … of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management ... as requested by department director or Medical Director . + Outcomes Management 1. Participates in...5 years Clinical experience + Req 2 years Ambulatory case management or utilization review… more
    University of Southern California (11/19/25)
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  • Medical Director - Medicaid (remote)

    Humana (Sacramento, CA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (12/07/25)
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