RN: Prior Authorization & Utilization Manager
$153.49k - $202.43kUniversity of California San Diego
The University of California San Diego is looking for a Prior Authorization UM Case Manager to oversee medical services and procedures facilitation. This role requires a Registered Nurse license in California and a minimum of two years' experience in prior authorization or related fields. Responsibilities include coordinating with providers and insurers to ensure efficient prior authorization and adherence to guidelines. The role offers a hybrid work model, one day onsite and the rest remote, with a pay scale ranging from $153,488 to $202,431 annually. #J-18808-Ljbffr University of California San Diego
$153.49k - $202.43k
...Days, 8-Hour Shifts, Monday-Friday #139431 (RN) Prior Authorization UM Case Manager - Hybrid Extended Deadline: Tue 6/2/2026 Apply... ...years of recent RN experience in prior authorization, utilization management, or a related healthcare field. Proven...SuggestedHourly payContract workLocal areaRemote workMonday to FridayDay shift1 day per week$2,605 per week
...Registered Nurse (RN) | Case Manager Location: San Diego, CA Agency: Prime Staffing... ...Assessment/ Order DME, Plan of Care, Prior Authorization*, Prior Authorizations* Unit Details... ...clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing...SuggestedPermanent employmentFull timeContract workTemporary workLocal areaFlexible hoursShift workNight shiftWeekend work$153.49k - $202.43k
...distinction earned by 10% of U.S. hospitals. The Prior Authorization UM Case Manager will manage the prior authorization process... ...State of California. Minimum two years recent RN experience in prior authorization, utilization management, or a related healthcare field....SuggestedHourly payContract workRemote workMonday to FridayDay shift1 day per week- ...Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests and conducts retrospective claims review for the services. Prior Authorization: obtain necessary medical/clinical information from multiple...SuggestedFull time
$2,605 per week
...Registered Nurse (RN) | Case Manager Location: San Diego, CA Agency: Prime Staffing Pay: $2,605 per week Shift Information... ...Act), Needs Assessment/ Order DME, Plan of Care, Prior Authorization*, Prior Authorizations* Unit Details Staffing & Scheduling...SuggestedFull timeContract workLocal areaFlexible hoursShift workNight shiftWeekend work- ...services so individuals no longer need to manage their medical care alone. This is a... ...supervision of the Clinical Services Manager, the RN Case Manager is responsible for... ...and medication delivery. Assist with utilization reduction by reviewing hospital documentation...Daily paidFull timeMonday to FridayFlexible hours
- (RN) Palliative Nurse Case Manager - Per Diem - 139924 UC San Diego Health is a Magnet designated organization, which is a prestigious recognition... ...illnesses, recent experience with processing prior authorizations, proven ability to collaborate effectively with...Daily paid
$91.16 per hour
...Days, 8-Hour Shift, Monday-Friday #139924 (RN) Palliative Nurse Case Manager - Per Diem Filing Deadline: Tue 6/9/2026 Apply... ...illnesses. Recent experience with processing prior authorizations. Proven ability to collaborate effectively with interdisciplinary...Hourly payDaily paidContract workLocal areaMonday to FridayDay shift- ...Description Job Description Responsible for oversight and care management of hospice patients. Responsible for assessments and care... ...previous illness(es). - Provides professional nursing care by utilizing all elements of nursing process. - Assesses and evaluates...
$90.86k - $136.29k
...Utilization Management Nurse, Senior The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines... ..., Medi-Cal or Medicare. Successful RN candidate reviews authorization...Full timeContract workPart timeWork at officeLocal areaRemote workWork from homeHome office2 days per week$19.47 - $38.08 per hour
...Under the general direction of the Utilization Management Manager, you will be responsible for... ...concurrent, and retrospective referrals and authorizations for medical necessity and... ...Utilization Management experience including Prior Authorization Preferred Qualifications...Hourly payMinimum wageWork experience placementWork at officeLocal areaWork from home- ...Job Summary As a Clinical Services Manager - RN Telephonic Case Management, you will ensure optimum recovery on every claim while establishing... .... Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment...
- ...Time Certified Case Manager (CCM) - Commission for... ...Registered Nurse (RN) - CA Board of Registered... ...regulatory/financial/utilization review demands to assure... ...early referrals and authorization for SNF, Rehab, homecare... ..., and obtains prior authorization for in network...Hourly payDaily paidShift workWeekend work
$90k - $110k
...RN Case Manager Empowering Wellness, Transforming Lives Optima Medical Management Group... ...Case Manager serves as the clinical authority for ECM care planning, ensuring medical... ...based on medical history, diagnoses, utilization patterns, medications, and risk indicators...Full timeTemporary workLocal areaImmediate startFlexible hours$58.87 - $101.33 per hour
.../2026 JOB SUMMARY: Case Managers function as liaisons between... ...of care, and implementing the utilization management process for acute... ...care guidelines with a focus on authorization and reimbursement,... ...Heart Association) California RN License Bachelor's Degree...Casual work- ...with an assigned panel of physicians to manage the patients specialized needs. The... ...recommendations for alternative levels of care and utilization of resources, promotes self-care... ..., discharge planning and obtaining all authorizations/approvals/transfers as needed for...Daily paidContract workWork at office
$55 - $60 per hour
...assistant" Hospice Registered Nurse Case Manager - Leadership Role Lead with Compassion... ...Care Are you an experienced Hospice RN who thrives in leadership and is... ...structures, and unique living conditions. Utilize a tablet or laptop for real-time medical...Hourly payLocal area- ...The Registered Nurse Case Manager plans, organizes and directs care... ...professional nursing care by utilizing all elements of nursing process... ...applicable laws/regulations. The RN Case Manager, when assigned by... ...a minimum of one year with prior LVN experience in public...Part timeLocal areaFlexible hours
- ...Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized... ...Requires maintaining an active, unrestricted RN license in assigned states or the ability to...Full timeWork at office
- ...St. Paul’s PACE provide a hands-on approach coordinating medical, social, and home care services so individuals no longer need to manage their medical care alone. The typical schedule for the position is Monday - Friday, 8:00AM - 4:30PM. Job Summary : Under the...Daily paidMonday to FridayFlexible hours
- ...Job Title/Position: Registered Nurse Case Manager (work from home and travel position... ...). Provides professional nursing care by utilizing all elements of nursing process. Assesses... ...National League for Nursing and a current RN license. Minimum of two years’ experience...
$124.23k - $207.05k
...Senior Project Manager The Senior Project Manager is expected to develop and maintain a client base, manage Site Utilities sales, and manage the field labor needs for each project in conjunction with field leadership. The Senior Project Manager will use judgment and...Temporary workFor subcontractorWork at officeMonday to Friday$84.07k - $163.93k
...DESCRIPTION Job Summary Leads and manages multidisciplinary team of... ...functions: care management, utilization management, behavioral... ...management, utilization management (prior authorizations, inpatient/outpatient... .... • Registered Nurse (RN), Licensed Vocational Nurse...Contract workWork experience placementWork at officeLocal area- ...Manager Medical Management - Health Services Full-time Company... ...unencumbered California RN license o Graduate of NLN... ...Minimum of three (3) years of Utilization/Quality/Case Management... ...Management approach that includes prior authorization, complex case management,...Full timeLocal areaWeekend workDay shift
$152k - $202k
...Invivyd received emergency use authorization (EUA) from the U.S. FDA for... ...The Field Reimbursement Manager (FRM) serves as a key field-... ...expertise in claims submissions, prior authorization processes,... ...practices to understand their utilization of reimbursement support...Full timeContract workTemporary workPrivate practiceWork at officeRemote work$120k - $180k
Henkels & McCoy West is seeking a Senior Project Manager to oversee construction projects in California. The role requires 8+ years of project management experience in the utilities sector, demonstrating leadership and strong financial skills. Responsibilities include...$120k - $180k
Henkels & McCoy is seeking a Senior Project Manager in San Diego, California to oversee small to mid-scale construction projects. The... ...have over 8 years of experience in project management within the utilities sector, strong budgeting skills, and the ability to lead cross-...$30.64 - $45.8 per hour
...registered nurse to fill a Medical Case Manager position in San Diego, CA. Work from home... ...the employer, and the referral source Utilizes their medical and nursing knowledge to... ...EDUCATION & EXPERIENCE: Experience as an RN Medical Case Manager is ideal, or a...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workWork from homeMonday to FridayFlexible hoursNight shift$64.37 - $88.51 per hour
...the organization. In addition, responsibilities include leading, managing and overseeing daily operational activities of the program.... ...PREFERRED QUALIFICATIONS: Master's Degree NRP (AAP) California RN or RT license: If RT license - Registered Respiratory Therapist...Immediate start$30.37 - $61.79 per hour
...JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary... ...combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice....Hourly payWork experience placementWork at officeRemote work
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