• Utilization Management…

    CVS Health (Sacramento, CA)
    …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
    CVS Health (10/26/25)
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  • Clinical Registered Nurse…

    Cognizant (Sacramento, CA)
    …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … more
    Cognizant (10/07/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management ...needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management … more
    Ventura County (09/27/25)
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  • Senior Registered Nurse - Hospital…

    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...needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management … more
    Ventura County (09/21/25)
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  • Utilization Management Nurse…

    CVS Health (Sacramento, CA)
    … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management / Medical…

    Elevance Health (Walnut Creek, CA)
    Utilization Management / Medical Management Nurse - CA (JR169412) **Virtual:** This role enables associates to work virtually full-time, with the ... - 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of... experience and requires a minimum of 2 years clinical , utilization review, or managed care experience;… more
    Elevance Health (10/22/25)
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  • Registered Nurse - Utilization…

    ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (09/13/25)
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  • Utilization Management…

    CVS Health (Sacramento, CA)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse

    Insight Global (Campbell, CA)
    …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Apply specific health plan guidelines and policies - Review clinical notes and identify key medical criteria - Communicate...Requirements - Current California RN or LVN license - Clinical hospital experience (minimum 2 years preferred) - Strong… more
    Insight Global (10/16/25)
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  • Utilization Review Nurse

    UCLA Health (Los Angeles, CA)
    …The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting inpatient, partial ... hospital, and intensive outpatient programs. Performs clinical reviews with third party payors in order to...from the ARC or AHA, required. + Prior case management experience, highly desired + Proficient in Microsoft Office… more
    UCLA Health (10/24/25)
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