Utilization Review Nurse jobs in Orange, CA

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Nurse Manager of Case Management Utilization Review
Clinical Management Consultants - Orange, CA
$110,000 - $125,000 a year
Nurse Manager of Case Management, Nursing Manager of Care Management, RN Manager of Care Coordination, Nurse Manager of Utilization Review, Director of Case...
Sponsored by Clinical Management Consultants - 6 days ago
Prior Authorization Case Manager
Regal Medical Group - Orange, CA
Knowledge of NCQA, CMS, HSAG, and health plan requirements related to utilization management. The PACM will review for appropriate care and setting, and...
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Sponsored by Regal Medical Group - 30+ days ago

Grievance and Appeals Nurse Specialist Needed!

HealthCare Talent - Orange, CA
Clinical review processes including how to analyze and research clinical issues. Conduct research on standards of practice, regulations and policy and...
6 days ago - save job - email - more...

Duals Case Manager RN

Regal Medical Group - Orange, CA
2-3 years of utilization or HMO experience preferred. Communicates appropriately and clearly with physicians, In-Patient case managers and Prior-Authorization...
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4 days ago - save job - email - more...

Registered Nurse (RN) -Telephonic Complex, Case Manager - He...

Managed Care Resources - Santa Ana, CA
Guidelines and regulations relevant to case management and/or utilization management. Reviews, verifies and processes requests for referrals, outpatient...
5 days ago - save job - email - more...

Ambulatory Medical Case Manager

CalOptima 6 reviews - Orange, CA
Registered Nurse with an AS, BS or higher degree and current CA professional license. Identifies cases needing Manager, Director or Medical Director review or...
4 days ago - save job - email - more...

Case Manager EX - Case Management - F/T - Days

UC Irvine Health 2 reviews - Orange, CA 92868
$92,247.84 - $110,246.40 a year
Experience with and understanding of Utilization Review criteria and discharge planning. Performs the appropriate utilization review functions utilizing...
9 days ago - save job - email - more...

Case Manager/NICU Services - Case Management - F/T - Days

UC Irvine Health 2 reviews - Orange, CA 92868
$92,247.84 - $110,246.40 a year
Experience with and understanding of Utilization Review criteria and discharge planning. Performs the appropriate utilization review functions utilizing...
3 days ago - save job - email - more...

Staff Nurse (Non VA Care Case Manager)

Department of Veterans Affairs 842 reviews - Long Beach, CA
The Non VA Care Case Manager nurse may be asked to cover in other areas of Utilization Management as required....
17 days ago - save job - email - more...

RN Care Manager - Ambulatory Care

Heritage Healthcare (SJHH) - Fullerton, CA 92835
Active California Registered Nurse license. Organizes, coordinates, provides, modifies or obtains appropriate authorizations, utilizing appropriate utilization...
St. Joseph Health - 8 days ago - save job - email - more...

Utilization Management Nurse, LVN - Irvine, CA

UnitedHealth Group 1,727 reviews - Irvine, CA
Utilization review, concurrent review, utilization management, Irvine, CA. The Utilization Management Nurse is responsible for utilization management and...
13 days ago - save job - email - more...

Case Manager, Supervisor - Case Management - F/T - Days

UC Irvine Health 2 reviews - Orange, CA 92868
$89,900 - $161,800 a year
Administrative Nurse III. Experience with and understanding of Utilization Review criteria and discharge planning....
16 days ago - save job - email - more...
Nurse Manager Case Management
Clinical Management Consultants - Orange, CA
$107,450 - $141,450 a year
Case Nurse Manager, Care Nurse Manager, Utilization Review Nurse, Discharge Planner, Nurse Manager of Case Management, Nursing Manager of Care Management, RN...
Sponsored by Clinical Management Consultants - 4 days ago
RN or NP, Case Manager
Brand New Day, HMO - Westminster, CA
Minimum of 5 years of relevant Health Care experience, including a minimum 5 years relevant Health Plan experience in the areas of care coordination,...
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Sponsored by Brand New Day, HMO - 30+ days ago
Case Manager
MemorialCare Saddleback Memorial Medical Center Laguna H - Laguna Hills, CA
Ability to perform accurate chart review, analysis and data collection. Three to five years of acute hospital experience in clinical areas and specifically in...
Sponsored by MemorialCare - 6 days ago

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