• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (03/30/25)
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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 ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
    Dignity Health (06/01/25)
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  • Utilization Review Nurse LVN

    Prime Healthcare (Ontario, CA)
    …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/ utilization - review - nurse ... Plan. Qualifications Required qualifications: + Possess an active CA Licensed Vocational Nurse (LVN) license. + Minimum two years of experience in acute hospital… more
    Prime Healthcare (05/15/25)
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  • RN - Quality Assurance/ Utilization

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....support and review of medical claims and utilization practices. Complete medical necessity and level of care… more
    Emanate Health (04/23/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Sacramento, CA)
    AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position, offering ... flexibility of a home-based office. As the AVP of Utilization Review & Pharmacy, you will lead...of experience in the Nursing areaAND + Registered Professional Nurse license in residential area and in operational national/local… more
    Zurich NA (05/22/25)
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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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  • RN - Utilization Review *Part-Time…

    Providence (Mission Hills, CA)
    **Description** RN - Utilization Review for our centralized Utilization Management team for Southern California. This position is Remote (Working from Home ... candidates will reside/work in California. Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and… more
    Providence (05/30/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... utilization reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance with industry… more
    Alameda Health System (05/06/25)
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  • Corporate Director of Clinical Utilization

    Prime Healthcare (Ontario, CA)
    …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
    Prime Healthcare (04/17/25)
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