449 utilization jobs at 175 companies in Colton, CA
2mo
Save
Mark Applied
Hide
2mo
Utilization Specialist PRN
Riverside, California, United States
$31-$50/hrOnsiteAll Commitments Available
Acadia HealthcareNasdaq: ACHC: Provider of inpatient and outpatient behavioral health services.
2+ YOEUR utilization management role in behavioral health; monitor utilization; coordinate with managed care; review medical necessity; respond to denials; requires high school diploma; clinical experience; licensure/certifications preferred.
Electronic Medical Records, Managed Care Systems, Reimbursement Systems
Kaiser Permanente: Provides integrated medical care and health insurance plans.
Coordinate and supervise utilization data collection, analysis and reporting; strong analytic, verbal and computer skills; knowledge of health plan benefits and hospital operations; high school diploma required.
A&S Management: Operates social service programs and real estate for developmental disabilities.
1+ YOEHigh school/GED,1+ year admin/scheduling or data-entry experience (healthcare preferred),bilingual English/Spanish,proficient with Microsoft Office and EHR,valid driver's license and reliable transportation,HIPAA compliance and attention to detail.
AltaMed: Provides comprehensive healthcare services to underserved Southern California communities.
2+ YOEHigh school diploma required; 2+ years medical billing or utilization management experience with pre-authorizations and government program knowledge (Medi-Cal, CCS); MA or medical billing certificate preferred; prior lead experience preferred.
Redlands Community Hospital: Provides comprehensive medical, surgical, and emergency healthcare services.
2+ YOEHigh school diploma preferred; 2 years hospital experience in utilization review, case management or business office preferred; managed care experience and medical terminology knowledge desirable.
KPC Health: Operates a network of hospitals and diagnostic laboratories.
High school diploma, strong administrative and insurance knowledge, ability to manage payer correspondence, HIPAA compliance, typing 50 WPM, Microsoft Office proficiency; healthcare experience preferred.
Microsoft Word, Microsoft Outlook, Microsoft Excel, ICD-10, CPT
Alignment HealthNASDAQ: ALHC: Provides Medicare Advantage plans and coordinated clinical services for seniors.
5+ YOE5+ years nursing in managed care/utilization review; RN or LPN license; Bachelor’s in Nursing/Health or Education; experience in clinical training.
Cerritos or California or Nevada or Arizona or Oregon or Florida
$275k-$325k/yrRemoteFull Time
The Oncology InstituteNASDAQ: TOI: Provides medical oncology, hematology, and clinical trial services.
5+ YOEMedical degree (MD or DO) and oncology board certification; minimum 5 years clinical oncology experience and 2+ years utilization management experience; strong analytical and communication skills; ability to review treatment appropriateness.
3+ YOEActive RN licensure, graduate of accredited nursing program (diploma/associate required; BS/BSN preferred), 3+ years clinical experience (rehabilitation preferred), management/supervisory experience, national certification (CCM preferred), and Microsoft Office/Excel proficiency.
AMFM Healthcare: Providing residential and outpatient mental health treatment services.
0.5+ YOEMust be 18+, high school diploma or equivalent, pass background check, at least 6 months behavioral health/substance abuse experience, able to type 40 WPM, proficient with Microsoft Office/Adobe/G Suite, knowledge of insurance criteria.
Prime Healthcare: Operates community hospitals and provides healthcare services.
Knowledge of discharge planning/utilization/case management, high school diploma, basic-intermediate computer skills, current BCLS required; hospital experience preferred.
Prime Healthcare Services: Operates a nationwide network of acute care hospitals.
Knowledge of discharge planning/utilization management, basic-intermediate computer skills, high school diploma required; BCLS required upon hire; associates or LVN and hospital experience preferred.
San Bernardino Municipal Water Department: Provides municipal water and wastewater utility services.
5+ YOEFive years journey-level welding experience with water pipeline knowledge, HS/GED, SWRCB Water Distribution Operator Grade 1, valid CA Class C driver’s license, AWS 6G pipe welding cert within 12 months, respirator fit and physical ability.
Cucamonga Valley Water District: Provides water, wastewater, and recycled water utility services.
1+ YOERequires 1+ year water treatment experience, high school diploma or equivalent, possession of D1 and T2 CA-SWRCB certificates (T3 exam and comprehensive training within one year), valid California Class C driver’s license, and ability to perform plant operations and maintenance.
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Access
Registered Nurse - Utilization and Care Transitions
Riverside, California, United States
$50-$75/hrOnsiteFull Time
Neighborhood Healthcare: Provides integrated medical, dental, and behavioral health services.
3+ YOEBachelor's in nursing, active CA RN license, current AHA BLS (hands-on) required, 3+ years clinical nursing with 1+ year in transitional care/case management or utilization review, valid CA driver's license and auto insurance, ability to travel locally.
Medical Case Manager, BHI Utilization Management - Covered California
Orange or California
$91k-$145k/yrRemoteFull Time
CalOptima Health: Provides public health insurance for Orange County residents.
3+ YOECurrent California unrestricted license (LCSW, LPCC, LMFT, or RN), 3+ years clinical experience, utilization management reviewer experience, knowledge of ICD-10/CPT-4/HCPCS, and proficiency with Microsoft Office.
Microsoft Word, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, ICD-10, CPT-4, HCPCS
Astrana HealthNASDAQ: ASTH: Operates technology-powered platforms to coordinate and deliver medical care.
1+ YOEActive CA LVN license, 1+ year outpatient utilization management experience, proficiency with Microsoft Word/Excel/Outlook, open availability 8AM-8PM (M-Su), ability to follow medical necessity criteria and internal policies.
Microsoft Word, Microsoft Excel, Microsoft Outlook
Case Manager EX - Utilization Management-Days - Remote - Irvine
Irvine, California, United States
$69-$100/hrRemoteFull Time
University of California, Irvine: Public research university offering higher education and academic degrees.
5+ YOECurrent RN license and BLS; BSN required for external candidates; minimum 5 years clinical experience and 1 year case management; familiarity with InterQual, Joint Commission/CMS/CDPH/CCS; strong communication and computer skills.
Microsoft Windows, Microsoft Excel, Microsoft Access, Microsoft Word, Microsoft PowerPoint, internet, e-mail
Coordinator, Office Utilization Review (FT, Days) Monterey Park Hospital
Monterey Park, California, United States
OnsiteFull Time
AHMC Healthcare: Operates a network of acute care hospitals and medical centers.
2+ YOE2 years acute care experience preferred; knowledge of Google Workspace preferred; experience with admissions, medical records, or business office; clerical, documentation, and communication skills; ability to prepare TARs and process admissions.
Denver or Philadelphia or Redlands or Remote Eligible
$80k-$133k/yrRemoteFull Time
Esri: Developing software for digital mapping and spatial data analysis.
2+ YOE2+ years in utilities/telecommunications with ArcGIS; ArcGIS Utility Networks; GIS workflows; strong communication; Bachelor in geography or related field.