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Renown HealthLos Angeles,CA
Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...
NurseRemotelyLos Angeles,CA
OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations and coordinating with payors, patients, and interdisciplinary teams. This role emphasizes HIPAA...
Horizon Blue Cross Blue Shield of New JerseyLos Angeles,CA
Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...
Carisk PartnersLos Angeles,CA
About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...
University of Minnesota School of NursingLos Angeles,CA
UnitedHealthcare is seeking an experienced RN to provide frontline education and guidance to members across the continuum of care. You will handle medical questions, coordinate care, and refer to internal programs while delivering compassionate,...
Registered NurseLos Angeles,CA
UnitedHealthcare is seeking an experienced registered nurse to join a frontline clinical resource program that educates and supports members about health management. The role emphasizes customer service, nursing judgment, and collaboration to...
Grand RoundsLos Angeles,CA
Nurse Care Manager We're looking for Nurse Care Managers for our Care and Case Management team, who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading...
Providence Health & ServiceLos Angeles,CA
Utilization Review RN - Remote This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review...
LancesoftLos Angeles,CA
LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 10/19/2026 Duration: 13 weeks 40 hours per week Shift: 8...
HealthMap Solutions LLCLos Angeles,CA
HealthMap Solutions is seeking a Registered Nurse, Care Navigator/Case Manager to lead case management for kidney health, coordinating care and improving outcomes for a mixed caseload. You will document in Compass, perform health screenings,...
IncludedhealthLos Angeles,CA
Included Health is seeking a Maternity Nurse Care Manager to join our Care and Case Management team. This telephonic, remote role supports patients through pregnancy from preconception to postpartum with holistic, evidence-based care. You...
CommUnityCareLos Angeles,CA
Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...
GuidehealthLos Angeles,CA
Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...
Care Talk HealthLos Angeles,CA
Registered Nurse – Care Management (Remote) (Day Schedule) United States Job Title: Registered Nurse – Care Management (Day Schedule) Location: 100% Remote - United States Employment...
UHCLos Angeles,CA
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...
Hireops Staffing LlcLos Angeles,CA
JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...
Adventist HealthLos Angeles,CA
Job Title Case Management Nurse Job Description Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital,...
IstssLos Angeles,CA
UnitedHealth Group is seeking an OptumCare MBI NCM to serve as a clinical liaison, coordinating care across settings for high-need members. The role emphasizes evaluation, care planning, and documentation in EMR systems. The position allows...
Central California Alliance for HealthLos Angeles,CA
Utilization Management Nurse (RN) (Temporary) Remote in California We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed...
VITAS HealthcareLos Angeles,CA
The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...
DevSan Gabriel,CA
OverviewJobs for Humanity is partnering with CEDARS‑SINAI to build an inclusive and just employment ecosystem. We prioritize individuals from diverse communities including Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard...
Metropolitan Jewish Health SystemLos Angeles,CA
Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...
hireopsLos Angeles,CA
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 on government health care programs. Accountabilities include...
Cardinal HealthLos Angeles,CA
Cardinal Health in the United States is seeking a Nurse Care Manager to deliver individualized care coordination and patient education across oncology and chronic disease programs. You will work remotely or via the onsite clinical team to bridge...
RXInsiderLos Angeles,CA
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

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