• 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 + ... FTE:1 + Posted:July 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review ...in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge… more
    Alameda Health System (07/29/25)
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  • Case Manager , RN - Utilization…

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/case- manager %2c-rn utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015.… more
    Prime Healthcare (06/24/25)
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  • Utilization Review Nurse

    Dignity Health (Carmichael, CA)
    **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
    Dignity Health (07/25/25)
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  • Utilization Review RN

    Prime Healthcare (Ontario, CA)
    …of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of experience ... in utilization review , referrals, authorizations, denials and appeals. + Current BCLS (AHA) certificate upon hire and maintain current. + Knowledge of MCG… more
    Prime Healthcare (07/29/25)
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  • Case Manager (RN) - Utilization…

    Prime Healthcare (Montclair, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/215040/case- manager -%28rn%29 utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015.… more
    Prime Healthcare (07/15/25)
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  • Case Manager (RN) - Utilization…

    Prime Healthcare (San Dimas, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015.… more
    Prime Healthcare (07/15/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …knowledge of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in ... System Utilization Management SUM Specialist + Oakland, CA +...Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity… more
    Alameda Health System (07/19/25)
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  • Utilization Management Admissions Liaison…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
    LA Care Health Plan (07/12/25)
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  • Utilization Management Nurse Specialist RN…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically… more
    LA Care Health Plan (07/08/25)
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  • Case Manager , Registered Nurse

    Sutter Health (Roseville, CA)
    …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... SMCS-Valley Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted… more
    Sutter Health (07/29/25)
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