- Elevance Health (Walnut Creek, CA)
- Utilization Management / Medical Management Nurse - CA (JR169412) **Virtual:** This role enables associates to work virtually full-time, with the ... 8am - 6pm PST. Rotating Weekends and holidays. The ** Medical Management Nurse** is responsible for review...Med/Surg, Critical Care, ER, Telemetry, etc. strongly preferred. + Utilization management /review within managed care or hospital… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Ventura County (Ventura, CA)
- …knowledge of: + The theory, techniques, and practices of professional nursing within utilization management ; + medical terminology and hospital routine and ... Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem… more
- Centene Corporation (Sacramento, CA)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Molina Healthcare (San Francisco, CA)
- …Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management ... clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and accrediting… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...0307HCA-25AP (ECA) Department Health Care Agency Division Ventura County Medical Center and/or Santa Paula Hospital Opening Date 09/10/2025… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** Join Humana as a Utilization Management (UM) Strategy Principal, and play a pivotal role within Humana's ... Utilization Management Strategy team, a collaborative group...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
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