California Licensed Utilization Management Nurse
VirtualVocationsEscondido, California, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a UM Nurse, RN for the Weekend Shift.
Key Responsibilities
Conduct prospective and concurrent / retrospective reviews of referrals to ensure compliance with regulatory requirements
Utilize nationally recognized UM criteria to meet Member needs effectively
Support the Quality Program goals including HEDIS, CAHPS, and NCQA Accreditation
Required Qualifications
Two or more years of utilization management experience in a healthcare delivery setting or an acute care facility
Experience in an HMO or Managed Care setting is preferred
High school diploma or GED required; Bachelor's degree in Nursing preferred
Possession of an active, unrestricted Registered Nurse (RN) license issued by the California BRN
Valid California Driver's license is required
serp_jobs.job_alerts.create_a_job
Utilization Management Nurse • Escondido, California, United States
Job_description.internal_linking.related_jobs A company is looking for a UM Nurse, RN for the Weekend Shift.Key Responsibilities Conduct prospective and concurrent / retrospective reviews of referrals to ensure compliance with regulatory requi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Concurrent Review Nurse (RN) (Temporary).Key Responsibilities Performs concurrent, post-service, and retrospective reviews of acute in-patient care services using estab...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a UM Case Manager.Key Responsibilities Provide case management services including pre-certification, assessment, and coordination of care for assigned members Document a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Preservice Review Nurse RN - Remote.Key Responsibilities Perform clinical coverage review services, interpreting state and federal mandates and clinical information Co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Care Manager (RN) to develop and facilitate care management activities for members with physical needs.
Key Responsibilities Evaluate member needs and barriers to care, ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Psychiatric Technician - Statewide in CA Position : Psychiatric Technician Location : Statewide - Multiple Locations Throughout California Annual Salary Range : $71,460 - $105,084 California Correctio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Utilization Management RN PRN.Key Responsibilities Analyze patient records to assess hospital admissions, treatment legitimacy, and appropriate care levels Facilitate ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Manager, Utilization Management to oversee two Utilization Management teams and ensure compliance with healthcare guidelines.
Key Responsibilities Manage prior authoriza...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Nurse Itemized Bill Reviewer (IBR Analyst).Key Responsibilities Perform in-depth reviews of medical claims using UB-04 and itemized statements Verify accuracy of itemi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Psychiatric Mental Health Nurse Practitioner.Key Responsibilities Provide psychiatric care and medication management to clients via telehealth Conduct psychiatric eval...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Stability Healthcare is seeking an experienced Outpatient Clinic Registered Nurse for an exciting Travel Nursing job in San Diego, CA.
Shift : 5x8 hr days Start Date : ASAP Duration : 13 weeks Pay : $27...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Clinical Appeals RN, fully remote, requiring 4 or 5 workdays per week with weekends required.Key Responsibilities Review medical records and verify if requested service...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Medical Solutions is seeking an experienced Stepdown Unit Registered Nurse for an exciting Travel Nursing job in San Diego, CA.
Shift : 2x12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Bilingual Family Nurse Practitioner (CA Licensed, Spanish Speaking).Key Responsibilities Provide virtual preventive care for underserved patients using internal care de...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Eligible Special Selection clients should contact their Disability Counselor for assistance.The qualifications of this position have been slightly modified as of 10 / 3 / 2025.The Manager of Utilizatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Supervisor of Utilization Management to oversee a clinical review team ensuring appropriate care for members.
Key Responsibilities Supervises the day-to-day activities o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Nurse Practitioner.Key Responsibilities : Review member's medical history and conduct telehealth consultations Generate medical orders and prepare reports on imaging st...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Telehealth Nurse Practitioner for a virtual women's health clinic in California.Key Responsibilities Provide direct patient care during virtual clinic visits and ensure...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for an RN Central Utilization Management.Key Responsibilities Conduct medical necessity reviews and clinical assessments for patient admissions and ongoing care Ensure timel...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Southern California Physicians Managed Care Service.We're committed to delivering innovative leadership in health care management, continuously improving services for our clients and communities.Yo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
California Licensed Utilization Management Nurse
VirtualVocationsEl Cajon, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Concurrent Review Nurse
VirtualVocationsEl Cajon, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Licensed Utilization Management Case Manager
VirtualVocationsEscondido, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Florida Licensed Preservice Review Nurse
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Care Manager
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Psychiatric Technician - Statewide in CA
California Department of Corrections and RehabilitationAlpine, California, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Florida Licensed Utilization Management RN
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Oklahoma Licensed Utilization Manager
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Nurse Reviewer
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Psychiatric Nurse Practitioner
VirtualVocationsEscondido, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse - RN - Outpatient Clinic - $2776 / Week - Hiring Now
Stability HealthcareEncinitas, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Clinical Appeals RN
VirtualVocationsEl Cajon, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse - RN - SDU - Stepdown Unit - $2982.98 / Week
Medical SolutionsEncinitas, CA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Bilingual Family Nurse Practitioner
VirtualVocationsEscondido, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
(RN) Manager, Utilization Management - 136750
UC San Diego HealthSan Diego, CA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Utilization Management Supervisor
VirtualVocationsChula Vista, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Nurse Practitioner
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Telehealth Nurse Practitioner
VirtualVocationsChula Vista, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Georgia Licensed Utilization Management RN
VirtualVocationsOceanside, California, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Utilization Management Representative
OptumSAN DIEGO, CA, United Statesserp_jobs.job_card.full_time