• Utilization Management Nurse

    Humana (Sacramento, CA)
    …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... receives guidance where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical knowledge, communication… more
    Humana (06/05/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management more
    The County of Los Angeles (05/22/25)
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  • Director, Utilization Management

    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
    Alameda Health System (05/06/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening ... + Req #:41910-31048 + FTE:1 + Posted:May 22, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
    Alameda Health System (05/23/25)
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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 Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
    LA Care Health Plan (04/11/25)
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  • National Utilization Management

    Humana (Sacramento, CA)
    …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
    Humana (06/06/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/209416/director-of-case- management utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityCentinela… more
    Prime Healthcare (05/30/25)
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  • Pre-Service Utilization Management

    Dignity Health (Bakersfield, CA)
    …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the ... The position partners with both the Pre-Service and In-Patient Utilization Management teams. Ensures to monitor and...- Ensures that there is evidence that the UM nurse reviewer documented communications with the requesting provider to… more
    Dignity Health (05/15/25)
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  • Corporate Director of Clinical Utilization

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

    Zurich NA (Sacramento, CA)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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