• 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)
    - Related Jobs

  • 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 - ... 22, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN ...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (05/23/25)
    - Related Jobs

  • 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: ... 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)
    - Related Jobs

  • Manager, Care Coordination ( RN )…

    Stanford Health Care (Palo Alto, CA)
    …to create an effective plan to address them. **Licenses and Certifications** + Nursing / RN - Registered Nurse - State Licensure and/or Compact State ... Preferred Qualifications: - 5+ years of experience as an RN (in an Emergency Department) - 3+ years of...leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by… more
    Stanford Health Care (05/23/25)
    - Related Jobs

  • 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...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
    Prime Healthcare (04/17/25)
    - Related Jobs

  • Utilization Management RN

    WelbeHealth (Los Angeles, CA)
    …compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of ... a critical role in our participant's journey and our Utilization Management team ensures we can provide...external), clinical staff, and others to timely resolve any utilization management issues **Job Requirements:** + Minimum… more
    WelbeHealth (05/23/25)
    - Related Jobs

  • Case Manager ( RN ) - Utilization…

    Prime Healthcare (Montclair, CA)
    …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/208989/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMontclair Hospital Medical Center… more
    Prime Healthcare (05/28/25)
    - Related Jobs

  • Utilization Management

    Dignity Health (Rancho Cordova, CA)
    …to collaborate with members of NSSA Regional Health Services Research (HSR), Utilization Management , Quality Management and various other departments, ... experience with quality assurance/improvement is desirable, preferably as an RN , LVN, Pharmacist, Radiology Technologist, Rehabilitation Therapist, Respiratory Therapist,… more
    Dignity Health (05/17/25)
    - Related Jobs

  • 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 ... and acumen to develop models and procedures, and monitor trends, within Nurse Case Management . RN and current unrestricted nursing license required. **Job… more
    The Cigna Group (05/29/25)
    - Related Jobs

  • RN - Quality Assurance/ Utilization…

    Emanate Health (Covina, CA)
    …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
    Emanate Health (04/23/25)
    - Related Jobs