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Utilization Management Nurse Specialist RN II (ALD) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00...

Monterey Park Hospital seeks a Case Manager for the Utilization Review Department. This is a full-time, 8-hour day shift role from Saturday through Wednesday, reporting to the Chief Operating Officer.The Case Manager will coordinate Continuum of...

Archimedes is seeking a Supervisor, Clinical Operations to oversee high-touch clinical case management for specialty drug programs. This fully remote role involves coordinating telephonic member and provider support, ensuring quality outcomes and...

Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Nurse 3 Job Location: Redondo Beach, CA...

Earlwood Center in Torrance, CA seeks a dedicated Full-Time Case Manager (LPN/LVN) to oversee resident care from admission through discharge. You will coordinate services, collaborate with families and healthcare teams, and ensure high-quality,...

Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to...

General Information Press space or enter keys to toggle section visibility Work Location: Santa Monica, CA, USA Work Schedule 4-day 10-hour shifts, 7:00am-5:30pm; may...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Case Manager Care Coordinator The Case Manager Care Coordinator coordinates the care and service of patient populations from admission through discharge. The Care Coordinator clinically assesses, plans, implements, coordinates, monitors,...

The Department of Family Medicine of the Keck School of Medicine of USC provides care for every member of the family, across generations and over lifetimes. We aim to enhance the quality of life for underserved and vulnerable patients while...

Job Opportunity We are recruiting for an RN or LVN Case Management with strong UM skills. Utilization Management. shift is 0800-1700 Strong UM Review nurses, LVN or RN Candidate MUST have UM Review experience, Aware of Turn-Around-Time...

Bay Crest Care Center in Torrance, CA is seeking a Full-Time Case Manager (LPN/LVN) to join their healthcare team. The role involves managing resident care through various stages and collaborating with healthcare providers. Candidates must have...

Registered Nurse (RN) Utilization Management We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate...

Registered Nurse (RN) - Case Management (CM) Location: 501 South Buena Vista Street, Burbank, CA, 91505 Work type: Travel Contract Estimated pay: $2550 per week (estimated) Shift: Days Start date: 11-02-2026...

Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

Medical Management And Health Education Program Coordinator The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers...

Utilization Management Nurse Specialist RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary...

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we...

TAG MedStaffing is seeking a Registered Nurse Care Manager for our client. The role focuses on chronic disease management, patient education, and care coordination within a technology-driven healthcare organization. It offers remote work...

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

Job Summary and Responsibilities As our Utilization Review Nurse at the Utilization Management Hub, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical...

description: Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians,...