• Novo Nordisk Inc. (San Mateo, CA)
    …Externally, the DCS maintains relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other paramedical ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
    HireLifeScience (05/23/25)
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  • RN Utilization Management Clinical Reviewer

    The Cigna Group (Sacramento, CA)
    …**Job Description Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate ... for inpatient acute care, rehabilitation, referrals, and select outpatient services. May review initial liability disability claims to determine extent and impact of… more
    The Cigna Group (05/29/25)
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  • Utilization Review Nurse

    Dignity Health (Carmichael, CA)
    **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The **Utilization Review RN** is responsible for the ... in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and… more
    Dignity Health (06/01/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (03/30/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Sacramento, CA)
    …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
    Centene Corporation (05/30/25)
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  • Appeals Licensed Practical Nurse

    Evolent (Sacramento, CA)
    …client policies and procedures while complying with timeliness guidelines. Our clinical nurse reviewer team values collaboration, continuous learning, and a ... the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...set up the appeal, physicians and other clinicians who review the appeal, the claims department to review more
    Evolent (05/16/25)
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  • Quality Management Clinical Nurse

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or… more
    UCLA Health (03/12/25)
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  • Utilization Review Nurse LVN

    Prime Healthcare (Ontario, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/utilization- review - nurse -lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Plan. Qualifications Required qualifications: + Possess an active CA Licensed Vocational Nurse (LVN) license. + Minimum two years of experience in acute hospital… more
    Prime Healthcare (05/15/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (San Francisco, CA)
    Summary The Patient Flow Utilization Management/Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical coordination and ... oversight for their patient population. The Nurse is primarily responsible and accountable for assessing, planning, implementing, and evaluating direct and indirect… more
    Veterans Affairs, Veterans Health Administration (05/24/25)
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