• National Utilization

    Humana (Sacramento, CA)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental… more
    Alameda Health System (05/06/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/209416/ director -of-case- management utilization - management ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens… more
    Prime Healthcare (05/30/25)
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  • Corporate Director of Clinical…

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
    Prime Healthcare (04/17/25)
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  • Care Coordinator - SCMG Utilization

    Sharp HealthCare (San Diego, CA)
    …The UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient ... care, as it related to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager, areas of UM non-compliance… more
    Sharp HealthCare (06/05/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Sacramento, CA)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • RN Utilization Management Clinical…

    The Cigna Group (Sacramento, CA)
    …Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate health care ... facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness...level of care. + Consults with manager and medical director to resolve any issues related to delay of… more
    The Cigna Group (05/29/25)
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  • 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 (06/05/25)
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  • Divisional Director of Care…

    CenterWell (Sacramento, CA)
    …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with travel requirements ... solutions that will lead to acute and post-acute care utilization reductions aligned with the PCO's objectives and goals....impact** **Required Qualifications:** + **At least 5 years of Management experience required** ; _3-5 years of Director more
    CenterWell (05/23/25)
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  • Social Worker MSW - Utilization Review

    Providence (Napa, CA)
    **Description** Under minimal supervision and at the direction of the Case Management Director , the Inpatient Social Worker/Patient Counselor is responsible for ... race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status,… more
    Providence (04/15/25)
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