RN Utilization Management Specialist
Ocean State Job Lot
Ocean State Job Lot is seeking a Registered Nurse for Utilization Management in California. The RN UM will support various UM functions including care coordination, denials management, and insurance authorization processes. Candidates must have an Associate Degree in Nursing, a current California RN license, and experience in Case or Utilization Management. This role focuses on enhancing quality care and minimizing adverse outcomes through effective communication and collaboration with the care team. Bilingual candidates are preferred, and the position offers an opportunity to engage with the community health care organizations. #J-18808-Ljbffr
- ...assigned panel of physicians to manage the patients specialized... ...alternative levels of care and utilization of resources, promotes self-care... ...Primary Care Physicians, Specialists and various disciplines on the... ...of clinical experience as an RN in an acute care or ambulatory...SuggestedContract workWork at officeWeekend work
- LaSalle Medical Associates IPA is seeking an On-Call Registered Nurse (RN) in California responsible for providing after-hours medical management coverage. This role involves supporting utilization management, care coordination, and urgent authorization tasks to ensure...SuggestedNight shiftWeekend workAfternoon shift
- The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include: the e-TAR process, denials management, and the UM process. Coordinates care submission relating to the process of health care utilization from the point...SuggestedFull timeLocal area
$75.3k - $135.4k
...Corporation is seeking a Clinical Supervisor to oversee the utilization management team ensuring appropriate care for members. The ideal candidate... ...years of experience in a related field, along with an active RN license in California. This position offers a salary range...SuggestedRemote job$75.3k - $135.4k
...a clinical professional on our Medical Management/Health Services team. Centene is a diversified... .... Supervises day-to-day activities of utilization management team. Monitors and tracks UM... ...preferred. License/Certification RN - Registered Nurse - State Licensure and...SuggestedFull timePart timeWork at officeRemote workFlexible hours- Centene Corp. is seeking a Supervisor, Utilization Management (RN) to lead and supervise our Clinical Review team. This role focuses on ensuring appropriate care for our members and promotes adherence to compliance standards through effective team management and continuous...Remote jobFlexible hours
- ...Alignment Healthcare LLC is seeking a Lead Utilization Management Nurse, responsible for reviewing inpatient service requests while leading a team... ...strong communication skills and a valid California LVN or RN license. The role includes mentoring and training, along with...Remote work
$85.7k - $128.54k
...2E Alignment Healthcare USA, LLC is seeking a Supervisor for Utilization Management in California. The role includes overseeing the UM department... ...experience, an accredited nursing background, and must hold an active RN or LVN license in California. Knowledge of Medicare Managed...$85.7k - $128.54k
The Supervisor, Utilization Management (UM), reports to the Manager of UM and oversees the UM department, leading a clinical team and ensuring compliance... ...Nursing program. Licensure: Active, valid, and unrestricted RN or LVN license in California (non‑compact). Upon hire, must...Remote jobLocal area- ...Nurse Professionals is seeking an experienced travel nurse RN for Acute Care Case Management in Carmichael, California. This role requires at least 2... ...experience and proficiency in discharge planning and utilization management. Ideal candidates will hold an active BLS and...Contract workDay shift
- RN.com is seeking a dedicated RN Case Manager in California to facilitate discharge planning and perform utilization reviews. The ideal candidate should hold a valid CA RN license and a BSN, with substantial experience in acute care settings. Responsibilities include working...Immediate start
$85.7k - $128.54k
...while providing ample opportunities for growth and innovation. Utilization Management Nurse Lead Responsibilities Reviews reporting to assign tasks... ...have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact). Immediately upon hire,...Remote jobImmediate start$40 - $53 per hour
A leading vegetation management company in California is seeking a Safety Specialist. This role focuses on ensuring safety protocols during vegetation management... ...operations. Candidates must have experience in the utility space and be able to work outdoors in various...Hourly pay$134k - $160k
## Workday Specialist-FinApplylocations: Chatsworth, CAtime type: Full timeposted on: Posted 5 Days Agojob requisition id:... ...functional and technical support for Workday Financial Management applications utilized by Finance, People and Culture (P&C), and other departments...Full timeFor contractorsWork at officeLocal areaRemote workWeekend workAfternoon shift3 days per weekEarly shift- ...and Business Services Division. This position is responsible for administering the housing program for the parks and managing the operation and utilization of family facilities. Major Duties At the full performance level (GS-09) the major duties of this position include,...Permanent employmentTemporary workSeasonal workLocal area
$40 - $53 per hour
Safety Specialist Atlas Field Services (AFS) is currently seeking Vegetation Management Safety Professionals to join our team. Interested applicants must reside in the area... ...’s experience in vegetation management and utility space. Essential Duties And Responsibilities...Full timeFor contractorsLocal areaRemote workRelocationLong distance- ...Department is seeking a Senior Community Program Specialist to join our team! Family Health Services... ...reporting for the Enhanced Care Management and Community Supports program, while... ...data-driven decision making. Be able to utilize modern computing systems (Microsoft applications...Full timeContract workWork at officeLocal area
$117.54k - $144.62k
...commitment to safety, we are looking for a specialist with an investigator’s mindset, skills,... ..., Investigations, and Operations Senior Manager. Please Note: This role may review... ...extremism, and other high‑severity harms. Utilize internal tools, data analysis, and open‑...Full timeWork experience placementH1bWork at officeLocal areaImmediate startVisa sponsorshipMonday to Friday$66.12k - $104.4k
Overview The Project Specialist II is responsible for delivering and maintaining the network... ...events from inception to retrospective, managing schedules with minimal guidance. Gather... ...process improvements. Experience in regulated/utility environments is a strong plus. Excellent...Temporary workWork at officeFlexible hours$31.3 - $35.25 per hour
...Description The Patient Administrative Specialist is a flexibly staffed career ladder consists... ...to the appropriate level based on management's assessment of their job-related knowledge... ..., and processing internal forms. Utilizes all functionality of the telephone system...Hourly payFull timeWork experience placementWork at officeAfternoon shift$64.28k - $119.38k
Overview As an Associate System & Application Management & Support Specialist, you will manage service operations in the Swift Central Control Centre. Your role includes balancing routine operations with the development of automation tools, often working a rotational schedule...Shift work$27.61 - $53.83 per hour
Molina Healthcare is seeking a dedicated professional to provide support for clinical member services in California. The role includes assessing services to ensure compliance with regulations and optimizing member outcomes through effective collaboration and review processes...Hourly payWork at office$43.91k - $94.1k
...258006 Department - Sheriff Division - Management Services Opening Date - 07/23/2025 Closing... ...the position of INFORMATION TECHNOLOGY SPECIALIST Read On…This may be the role for you!... ...departments IT Specialists may be utilized in different ways depending on the department...Full timeWork experience placementWork at officeImmediate start- ...Scheduled Weekly Hours:**0**Job Description Summary:**The case management specialist is responsible for providing technical, administrative and... ...:*** Proficiency in medical terminology,* Experience in utilization review or discharge planning, financial counseling or registration...Daily paidSecond jobLocal areaShift work
- ...on the development, financing, and ownership of distributed and utility-scale clean energy projects across North America. The team... ...Development teams to model transactions, prepare financing materials, manage diligence processes, and help close financings across the firm’...
$25 per hour
...Position: Treasury Specialist- Warehouse Management Company: Guild Mortgage Pay Rate: $25.00/hr Department: Treasury- Warehouse Management Position Summary: The Treasury Specialist – Warehouse Management plays an important role in the organization by performing a number...Work at office- ...The Aerospace Sourcing Commodity Specialist III manages pricing, sourcing, part setup and all aspects of data within assigned commodity. Completes... ...sources in the event of supply chain disruptions. Utilizes software tools to conduct competitive bids. Participates in...Remote work
$89k - $136k
..., privacy, and responsible information management to ensure mission success.KBR is seeking... ...**Flight** **Operations Project Specialist** to support tasking at the Naval Air Warfare... ...tracking of flight qualifications, resource utilization, and scheduling priorities across...Contract workTemporary workFor contractorsLocal areaRelocation packageFlexible hours- ...Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality... ...Nurse License upon hire. 3 years experience in utilization management and/or case management. 3 years clinical experience in hospital...Work at office
$70k - $110k
...Emergency Management Specialists: Response Cadre Hagerty Consulting, Inc. (Hagerty) is the nation's leading emergency management and homeland security consulting firm. Known for its public spirit, innovative thinking, problem-solving, and exceptional people, Hagerty is...Full timeTemporary workWork at officeLocal areaImmediate startFlexible hoursShift work
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