• Utilization Review Specialist…

    Sutter Health (Berkeley, CA)
    …with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of ... to justify acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for concurrent … more
    Sutter Health (10/22/25)
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  • Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management...Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM),… more
    LA Care Health Plan (10/14/25)
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  • MSO Healthcare Contract Specialist

    HCA Healthcare (Campbell, CA)
    …find this opportunity compelling, we encourage you to apply for our Contract Specialist opening. We promptly review all applications. Highly qualified candidates ... individual is recognized. Submit your application for our Contract Specialist opening with HCA Healthcare today and find out...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
    HCA Healthcare (10/25/25)
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  • Care Management Specialist II, D-SNP Team…

    LA Care Health Plan (Los Angeles, CA)
    …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Care Management Specialist II, D-SNP Team (ALD) Job Category: Clinical...the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and… more
    LA Care Health Plan (10/21/25)
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  • Sr. Spec-PI-Quality/Safety

    Sharp HealthCare (La Mesa, CA)
    …**What You Will Do** The purpose of the Sr. Performance Improvement Specialist is to improve clinical outcomes including responsibilities relating to leading teams ... in the utilization of Change Acceleration Process and PI tools and...through measurement and analysis along with concurrent and retrospective review of performance information. Assists with operational planning and… more
    Sharp HealthCare (09/24/25)
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  • EHR Support Analyst II OR

    HCA Healthcare (Thousand Oaks, CA)
    …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... use within the facility. This individual works with the Division EHR Support Specialist Team and facility core team members to develop training materials and deliver… more
    HCA Healthcare (10/12/25)
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