363 utilization jobs at 158 companies in Menifee, CA
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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
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.
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.
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.
Santa Fe Irrigation District: Manages water resources and infrastructure for California communities.
Construction or water-utility experience; safety awareness; ability to perform physical outdoor labor; California Water Distribution Operator certificate (D1 within 12 months for Utility Worker I; D2 for Utility Worker II).
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.
Kaiser Permanente: Provides integrated medical care and health insurance plans.
2+ YOEActive California RN license, BLS, 2 years RN acute or case management experience, knowledge of utilization review/discharge planning and regulatory standards, computer literacy, strong communication and critical thinking.
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
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
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.
New York City or Milwaukee or Herndon or Dallas or Columbus or Kirkland or Irvine or Cincinnati or Cleveland or Oklahoma City or Austin or Albany or Chicago or Arlington or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Mountain View or Scottsdale or Morristown or San Francisco or Denver or Boston or Philadelphia or Des Moines or Overland Park or Los Angeles or Charlotte or Walnut Creek or Carmel or Seattle or Houston or Arlington or Atlanta or Redmond or Bentonville or Beaverton or Nashville or Detroit or San Diego
$139k-$434k/yrHybridFull Time
AccentureNYSE: ACN: Global provider of management consulting and technology services.
10+ YOE10+ years in utility GIS solution architecture with full‑lifecycle ArcGIS Utility Network implementations; experience advising utility executives, defining enterprise GIS architecture, and leading large transformation programs; must be eligible to work in the US and willing to travel.
City of Newport Beach: Provides municipal services and governance for the Newport Beach community.
1+ YOEPart-time/full-time Utilities Specialist with 1 year in water/wastewater utilities; high school diploma; California driver license; relevant certifications; pass background check.