• Prior Authorization RN

    Humana (Sacramento, CA)
    …part of our caring community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. ... This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that...make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin,… more
    Humana (12/18/25)
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  • UM Prior Authorization Review…

    UCLA Health (Los Angeles, CA)
    …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… more
    UCLA Health (10/03/25)
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  • Registered Nurse ( RN…

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager,...Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization , level of care and length ... + 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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  • Per Diem RN - Case Management - Sharp…

    Sharp HealthCare (La Mesa, CA)
    …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...services are directed to appropriate network providers, and obtains prior authorization for in network and out… more
    Sharp HealthCare (12/06/25)
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  • Case Manager II - Transition Planning - Sharp…

    Sharp HealthCare (San Diego, CA)
    …Master's Degree; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... case management, utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA...services are directed to appropriate network providers, and obtains prior authorization for in network and out… more
    Sharp HealthCare (12/18/25)
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  • Case Manager I - Transition Planner - Sharp…

    Sharp HealthCare (San Diego, CA)
    …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...services are directed to appropriate network providers, and obtains prior authorization for in network and out… more
    Sharp HealthCare (11/09/25)
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  • Care Manager ( RN )

    Stanford Health Care (Palo Alto, CA)
    …to identify trends and make recommendations for improvement. **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... ASA + Knowledge of medical management statistics relating to UM/CM and prior authorization process management. + Extensive knowledge of risk stratification… more
    Stanford Health Care (12/18/25)
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  • LVN/LPN - Pavilion Multispec Cl - Full Time 8 Hour…

    University of Southern California (Pasadena, CA)
    … (LVN) is an individual with specific knowledge and technical skills to assist the Registered Nurse in providing care for a designated group of patients. The LVN ... specific population of patients, under the direction of the Registered Nurse . Primary job duty surrounds all...ensuring 7 rights of medication safety. Initiates and completes prior authorization requests for medication as needed.… more
    University of Southern California (11/19/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Sacramento, CA)
    …management principles preferred. 25% Travel CA RN License Required **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization , Concurrent Review, and/or Retrospective Review Clinical… more
    Centene Corporation (12/11/25)
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  • Psychiatric Technician III

    The County of Los Angeles (Los Angeles, CA)
    …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... Psychiatrists in completing and checking for accuracy on Treatment Authorization Request (TAR) and Prior Authorization (PA) forms. + Promptly responds to… more
    The County of Los Angeles (10/06/25)
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