• Corporate Director of Clinical

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Corporate Director of Clinical Utilization Management ... + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
    Prime Healthcare (04/17/25)
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  • RN Utilization Management

    The Cigna Group (Sacramento, CA)
    …Other duties as required and related to this role. **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory of the ... to develop models and procedures, and monitor trends, within Nurse Case Management . RN and...Scope:** + Manages/Coordinates an active caseload of inpatient case management cases for Cigna. + Uses clinical more
    The Cigna Group (05/29/25)
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  • Supervisor, Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (04/11/25)
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  • RN Supervisor UM Inpatient Clinical

    Dignity Health (Bakersfield, CA)
    …will require Admin on-call on weekends/holidays.** **Position Summary:** The Supervisor of Utilization Management Inpatient Clinical will oversee clinical ... UM staff, ensuring they effectively perform utilization management (UM) reviews for inpatient cases. This role works...required. - Graduate of an accredited school of nursing: Registered Nursing. - Clear and current CA RN more
    Dignity Health (05/21/25)
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  • Clinical Documentation Integrity Specialist

    UCLA Health (Los Angeles, CA)
    …self-directed individual with: * Bachelor's degree in health-related field, preferred * A Registered Nurse ( RN ) license or MD diploma (or equivalent) ... or equivalent of education and experience in case management , utilization management or prior clinical documentation review experience, required *… more
    UCLA Health (05/30/25)
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  • Payment Integrity Nurse Coder RN III

    LA Care Health Plan (Los Angeles, CA)
    …8 years of clinical experience and a minimum of 3 years in utilization management or clinical coding. Investigation and/or auditing experience. Skills ... of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted… more
    LA Care Health Plan (04/11/25)
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  • Case Manager (CM) - Registered Nurse

    Select Medical (Los Angeles, CA)
    …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... in Social Work required or Current state licensure as a Registered Nurse required. + Previous experience in Case Management and Discharge Planning preferred.… more
    Select Medical (05/14/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (San Diego, CA)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
    Fresenius Medical Center (05/08/25)
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  • Registered Nurse ( RN )…

    ERP International (San Diego, CA)
    **Overview** ERP International is seeking a full-time **Perioperative** ** Registered Nurse ( RN )** to support the **Operating Room (OR) at** **Naval Medical ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (04/23/25)
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  • Clinical Registered Nurse

    Sharecare (Sacramento, CA)
    …ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification ... the disease management program intervention guidelines. A Clinical Registered Nurse is supervised...or call campaigns. + Accepts warm transfer calls from non- RN colleagues for assessment and/or additional discussion with participant… more
    Sharecare (05/10/25)
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