789 utilization jobs at 264 companies in Rancho Cucamonga, CA

2w
Save
Mark Applied
Hide
Utilization Clerk
Corona, California, United States
$23-$26/hr HybridFull Time
A&S Management
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.
Microsoft Office, WellSky, Family Room, EHR, EVV
6d
Save
Mark Applied
Hide
Utilization Review RN
Ontario, California, United States
$72k-$104k/yr OnsiteFull Time
Prime Healthcare
Prime Healthcare: Operates acute care hospitals and outpatient facilities in the US.
7+ YOERequires current state RN license, BCLS/BLS (AHA), knowledge of MCG or InterQual, minimum 7 years post-graduate nursing and 3+ years utilization review experience; strong clinical judgment and computer skills.
MCG Criteria, InterQual Criteria
2w
Save
Mark Applied
Hide
Utilization Review Nurse LVN
Ontario, California, United States
$72k-$100k/yr OnsiteFull Time
Prime Healthcare Services
Prime Healthcare Services: Operates a nationwide network of acute care hospitals.
2+ YOEActive CA LVN license, 2+ years acute hospital case management, utilization management experience, knowledge of claims, coding and billing, high school diploma/GED, strong interpersonal skills.
2w
Save
Mark Applied
Hide
Coordinator II, Utilization Management
Montebello, California, United States
$27-$34/hr HybridFull Time
AltaMed
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.
2mo
Save
Mark Applied
Hide
Utilization Specialist PRN
Riverside, California, United States
$31-$50/hr OnsiteContract
Acadia Healthcare
Acadia HealthcareNasdaq: ACHC: Operates specialized psychiatric and addiction treatment centers.
2+ YOEClinical experience (2+ years preferred), high school diploma or equivalent, preferred clinical licensure (LPN/RN/LMSW/LCSW/LPC/LPC-I), CPR and de-escalation/restraint certifications.
1w
Save
Mark Applied
Hide
Utilization Management Authorization Assistant
Redlands, California, United States
$23-$29/hr OnsiteFull Time
Redlands Community Hospital
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.
2mo
Save
Mark Applied
Hide
Acquisition Utilization Specialist
Los Angeles, California, United States
$72k-$75k/yr OnsiteFull Time
BDR Solutions
BDR Solutions: Provider of IT, engineering, and consulting for federal agencies.
3+ YOE3–5+ years federal acquisitions or healthcare procurement experience; bachelor’s in related field or equivalent; U.S. citizenship and ability to obtain Public Trust; experience with eCMS and procurement docs; strong Microsoft Office skills.
Electronic Contract Management System (eCMS), Microsoft Excel, Microsoft PowerPoint, Microsoft Word
1w
Save
Mark Applied
Hide
Utilization Review Tech
Santa Ana, California, United States
$25-$37/hr OnsiteFull Time
KPC Health
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
1mo
Save
Mark Applied
Hide
Utilization Review Coordinator
Long Beach, California, United States
$26-$28/hr OnsiteFull Time
View Behavioral Health
View Behavioral Health: Provides inpatient and outpatient psychiatric and behavioral health care.
2+ YOEAuditing charts, managing Medi-Cal/TAR submissions and appeals, verifying insurance eligibility, maintaining patient and payer records, 2+ years behavioral health/hospital experience, EHR proficiency, strong communication and computer skills.
Electronic Health Records (EHR), LA County TAR Unit Database, Medi-Cal system
2w
Save
Mark Applied
Hide
Utilization Review Clinician (RN) - OH License Required
Long Beach or United States
$24-$51/hr RemoteFull Time
Molina Healthcare
Molina HealthcareNYSE: MOH: Provides managed health insurance through government-sponsored benefit programs.
2+ YOEActive Ohio RN license required, 2+ years clinical/utilization or managed care experience, proficiency with Microsoft Office/EMR, strong communication, prioritization and critical-thinking skills.
Microsoft Office
3mo
Save
Mark Applied
Hide
Utilization Management Clinical Trainer (Hybrid Remote)
Orange or United States
$78k-$117k/yr HybridFull Time
Alignment Health
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.
1w
Save
Mark Applied
Hide
Utilization Review RN Part- time Day - REMOTE
Irvine, California, United States
$57-$89/hr RemotePart Time
Providence
Providence: Provides comprehensive healthcare services through hospitals, clinics, and health plans.
2+ YOEAssociate degree in Nursing, California RN license upon hire, 2 years UR remote or acute hospital case management experience; Interqual experience preferred; strong utilization management and clinical review skills.
Interqual
1w
Save
Mark Applied
Hide
Utilization Review RN - Part-time - REMOTE
Irvine, California, United States
$57-$89/hr RemotePart Time
Providence
Providence: A non-profit health system providing comprehensive medical care services.
2+ YOEAssociate's Degree in Nursing, California RN license upon hire, 2 years UR or acute hospital case management experience, knowledge of utilization management and medical necessity, strong communication and decision-making skills.
1w
Save
Mark Applied
Hide
Medical Director Utilization Management Oncology
Cerritos or California or Nevada or Arizona or Oregon or Florida
$275k-$325k/yr RemoteFull Time
The Oncology Institute
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.
1mo
Save
Mark Applied
Hide
Utilization Review Supervisor RN
Rancho Cucamonga, California, United States
$78k-$120k/yr RemoteFull Time
CorVel
CorVelNASDAQ: CRVL: Provides technology-driven risk management and healthcare cost containment services.
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.
Microsoft Office, Microsoft Excel
2mo
Save
Mark Applied
Hide
Utilization Review (UR) Assistant
Long Beach, California, United States
$21-$26/hr OnsiteFull Time
College Medical Center
College Medical Center: Community hospital providing acute care and behavioral health services.
1+ YOEHigh School graduate or GED preferred; 1 year acute care/hospital experience preferred; medical terminology knowledge required.
1mo
Save
Mark Applied
Hide
Utilization Management Nurse, Senior
El Dorado Hills or California or Long Beach or Lodi or Oakland or Rancho Cordova or Redding or San Diego or Woodland Hills
$91k-$154k/yr HybridFull Time
Ascendiun
Ascendiun: Nonprofit parent overseeing health insurance and clinical service organizations.
5+ YOEAssociate Degree in Nursing required, active unrestricted RN license (or ability to obtain additional state licenses within 90 days), 5+ years relevant experience in managed care or clinical setting, BLS preferred, ability to work rotating on-call/evening/weekend schedule.
22h
Save
Mark Applied
Hide
ED Case Management Utilization RN, Per Diem Night
Downey, California, United States
$78-$95/hr OnsitePart Time
Kaiser Permanente
Kaiser Permanente: Provides integrated medical care and health insurance plans.
2+ YOECalifornia RN license, BLS, accredited RN training, and two years of combined acute care or case management experience required; utilization review, discharge planning, case management, computer literacy, and communication skills required.
1mo
Save
Mark Applied
Hide
Utilization Management Supervisor, Non-Clinical
Los Angeles, California, United States
$71k-$145k/yr HybridFull Time
UCLA Health
UCLA Health: Provides comprehensive hospital services and academic medical research.
4+ YOE3+ MgmtHigh school diploma/GED or equivalent; 4+ years in managed care case management/care coordination, 3+ years in inpatient and ambulatory managed care referrals, 3+ years supervisory experience; experience with Epic/CareConnect and Microsoft Office.
Epic, CareConnect, Microsoft Excel, Microsoft Visio, Microsoft PowerPoint, Microsoft Word
1mo
Save
Mark Applied
Hide
Utilization Review Case Manager
San Juan Capistrano, California, United States
$30-$35/hr OnsiteFull Time
AMFM Healthcare
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.
Microsoft Office, Adobe Acrobat, G Suite