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
$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. Proven...SuggestedHourly payContract workRemote workMonday to FridayDay shift1 day per week$91.16 per hour
...throughout UCSD. The Per Diem Nurse Care Manager (NCM) will support the... ...Graduate from an accredited school of nursing RN license issued by the State of California... ...illnesses Recent experience with processing prior authorizations Proven ability to collaborate effectively...SuggestedHourly payDaily paidContract workMonday to FridayDay shift$91.16 per hour
...Days, 8-Hour Shift, Monday-Friday #139924 (RN) Palliative Nurse Case Manager - Per Diem Filing Deadline: Mon 6/15/2026... ...progressive illnesses. Recent experience with processing prior authorizations. Proven ability to collaborate effectively with...SuggestedHourly payDaily paidContract workLocal areaMonday to FridayDay shift- ...Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines... ...Commercial, Medi-Cal or Medicare. Successful RN candidate reviews authorization requests for...SuggestedFull timeWork at office
$153.47k - $202.43k
...CASE MGR EX Department: Care Management Hiring Pay Scale $153,466... ..., holidays #140038 (RN) Care Manager - Hillcrest... ...appropriateness criteria to resource utilization and discharge planning. The... ...date. Minimum of 3 years prior inpatient RN care manager...SuggestedHourly payContract workLocal areaMonday to FridayRotating shiftDay shift- ...What You Will Do The SRS RN CM II assesses,... ...regulatory/financial/utilization review demands to assure... ...nursing experience or case management experience 3 Years... ...including early referrals and authorization for SNF, Rehab,... ...providers, and obtains prior authorization for in network...Hourly payDaily paidShift workWeekend work
- ...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...
- ...services so individuals no longer need to manage their medical care alone. Job Summary... ...supervision of the Clinical Services Manager, the RN Case Manager is responsible for... ...coordination, and medication delivery. Assist with utilization reduction by reviewing hospital...Daily paidFlexible hours
- ...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...
- ...Summary The Registered Nurse Case Manager plans, organizes and directs... ...professional nursing care by utilizing all elements of nursing... ...applicable laws/regulations. The RN Case Manager, when assigned by... ...for a minimum of one year with prior LVN experience in public health...Full timeLocal areaFlexible 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$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- ...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
$149.7k - $297.7k
#139951 (RN) Nurse Manager, North County Cancer Services Filing Deadline: Tue 6/16/2026 Reassignment Applicants: Eligible Reassignment clients... ...workflows to optimize patient access, throughput, resource utilization, operational efficiency, and service excellence. Partners...Hourly pay$110.45k - $138.06k
...Position Summary The EPC Project Manager will be responsible for the management of all aspects of utility‑scale solar projects, including project planning, budgeting, buyout, project controls/reporting, scheduling, risk management, etc. This role is located full‑time...Full timeContract workFor subcontractorLocal areaRemote work$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-...$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$50 - $60 per hour
...A healthcare facility in San Diego is looking for a dedicated Utilization Review Nurse to join its team. The role involves conducting admission reviews, managing patient care for both inpatient and outpatient services, and submitting appeals to third party payers. The...Day shift$110.45k - $138.06k
...SOLV Energy, LLC is seeking an EPC Project Manager for utility-scale solar projects. The successful candidate will manage all aspects including planning, budgeting, and onsite execution. This role requires strong leadership skills and field construction management experience...Full time- ...is determined by employment status Job Summary The RN Case Manager is responsible to facilitate care along a continuum through... ...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and...ReliefFlexible hours
- ...regulatory requirements. This position integrates care coordination utilization management, and discharge planning. Responsibilities Patient... ...Required qualifications should include RN (minimum of B.S.N. preferred) with at least 5 year’s beside experience...Relocation packageFlexible hours
$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- ...The Case Management Society of America (CMSA) ® is hiring a Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse Care Manager... ...the Primary Care Department. Candidates must possess an active RN license and have experience in chronic disease management and patient...Full time
$61.74k - $90.16k
...direct and indirect nursing services to patients and families. Candidates must be graduates from nursing school and possess a California RN license, along with at least one year of clinical experience. The role requires effective communication and teamwork to coordinate...Hourly pay- ...Registered Nurse Care Manager is responsible and accountable... ...assigned panel(s) – utilizes registries – and... ...state licensing board prior to completion of the bridge... ...shift). Duties The PACT RN Care Manager assumes the... ...with appropriate authority 12 Performs other duties...Permanent employmentTemporary workImmediate startRemote workRelocation packageMonday to FridayShift work
- ...Scripps Health is seeking a Registered Nurse (RN) for the Family Medicine clinic in San Diego. This full-time role involves both on-site and remote work, primarily providing indirect patient care through phone and messages, with occasional direct care. The ideal candidate...Full timeRemote work
- Spectrum Healthcare Resources is seeking a Registered Nurse for the Physical Medicine TBI position at Naval Medical Center San Diego, California. This full-time role offers a Monday to Friday schedule with no federal holidays or weekends. The ideal candidate will have ...Full timeMonday to FridayWeekend work
$115k
...Position Overview Cheer Home Care is looking for a RN Care Case Coordinator who loves spending time with older adults and provides... ...excellent communication and problem‑solving skills. Primary care manager, coordinating care among caregivers, RNs, therapists, and outside...Work at officeWeekend workWeekday work- NALHE in San Diego, California, seeks a Registered Nurse to lead the health care team. This role involves providing professional nursing care while ensuring patient safety and quality through adherence to established standards and guidelines. The ideal candidate will have...
- ...collaboration with a multidisciplinary team. Applicants must have a California RN license and at least one year of clinical experience. The role requires strong communication skills and the ability to manage multiple patient needs effectively. The position features a 12-hour...Hourly payShift workNight shift
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