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33 utilization review jobs at 21 companies in San Jose, CA

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Utilization Review Coordinator
San Jose, California, United States
$195k-$249k/yr FieldTemporary
County of Santa Clara
County of Santa Clara: Provides public services and healthcare to Santa Clara County residents.
2+ YOECurrent unrestricted California RN license and two years of recent acute-care hospital nursing experience; utilization review experience is desirable.
InterQual, Milliman Care Guidelines (MCG)
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1w
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Utilization Review Liaison
Fremont, California, United States
$32-$44/hr OnsiteFull Time
Washington Hospital Healthcare System
Washington Hospital Healthcare System: Public healthcare district providing comprehensive medical and emergency services.
Coordinates insurance reviews and authorizations, submits clinical information, supports case management, obtains medical records, performs data entry, and tracks claims and denials.
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1mo
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Journeyman Lineman - QA Review Specialist
Oakland, California, United States
$73-$75/hr OnsiteFull Time
Paxon Energy
Paxon Energy: Provides engineering consulting and infrastructure inspection for energy utilities.
5+ YOEAuthorized to work in the US, high school diploma, valid driver's license and insurable driving record, 5+ years utility experience, Qualified Electrical Worker (QEW), proficiency with SAP, Trifacta, Sherlock, and Microsoft Office, willingness to travel.
SAP, Trifacta, Sherlock, Microsoft Office
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2mo
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RN- Care Review Clinician- Utilization Review (Remote- CA License Req)
San Francisco or Los Angeles or San Jose or San Diego or Sacramento or Long Beach or California
$30-$59/hr RemoteFull Time
Molina Healthcare
Molina HealthcareNYSE: MOH: Provides managed health insurance through government-sponsored benefit programs.
2+ YOEActive unrestricted RN license in state of practice (CA required for this posting), 2+ years clinical experience (acute care/prior authorization/managed care), UM/prior authorization experience preferred, Microsoft Office proficiency, strong communication and critical-thinking skills.
Microsoft Office, MCG
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2mo
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Orthopedic Surgeon Telecommute Medical Review Stream Physician
San Francisco, California, United States
$30-$90/hr RemoteContract
Concentra
ConcentraNYSE: CON: Provider of occupational health, urgent care, and physical therapy.
Board-certified MD/DO with active California medical license, current error & omissions liability coverage, active medical practice, ability to perform utilization and chart reviews, telephonic and written communication, and timely case documentation.
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3w
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Senior Utility Manager
San Francisco, California, United States
$135k-$200k/yr OnsiteFull Time
Cordoba Corporation
Cordoba Corporation: Provides engineering, construction management, and planning for infrastructure projects.
10+ YOEPE license preferred, bachelor’s in engineering or related, 10+ years utility coordination/management experience with dry utilities, ability to review plans, develop relocation strategies, and coordinate stakeholders.
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3w
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Utility Distribution Planner III
San Francisco, California, United States
$108k-$125k/yr OnsiteFull Time
E2 Consulting Engineers
E2 Consulting Engineers: Provides engineering and project management for infrastructure projects.
7+ YOEHigh school diploma,7+ years utility distribution planning or electric utility project review,knowledge of NESC/GO95/GO128,field inspection ability,and strong verbal/written communication.
AutoCAD
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2mo
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Clinical Quality Reviewer - BCBA
San Francisco, California, United States
$110k-$140k/yr HybridFull Time
Onos Health
Onos Health: AI-powered behavioral health platform for healthcare payers.
2+ YOECurrent BCBA in good standing, 2+ years ABA utilization/quality experience, experience reviewing ABA treatment plans and clinical documentation, auditing skills, strong written and analytical abilities.
EHR
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3w
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Case Manager III, Ambulatory ( RN )
San Francisco, California, United States
$91-$127/hr OnsiteFull Time
Sutter Health
Sutter Health: Operates an integrated network of hospitals and medical clinics.
5+ YOEActive California RN required, 5+ years relevant experience, utilization review and InterQual expertise, chart review, training delivery, Excel and Microsoft Office proficiency, knowledge of payer/regulatory rules.
InterQual, Microsoft Excel, Microsoft Word, Microsoft Outlook
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1mo
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Mechanical Utilities, BTM R&D
Austin or New York City or San Francisco or Seattle
$203k-$232k/yr OnsiteFull Time
Fluidstack
Fluidstack: Provides high-performance cloud GPU infrastructure for AI development.
Experience engineering balance-of-plant/utility systems (fuel gas, water, compressed air), knowledge of applicable codes, integrating packaged equipment, reviewing EPC packages, and identifying interface gaps.
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5d
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Delegation Operations Nurse Auditor - LVN, Experienced
Long Beach or California or El Dorado Hills or Lodi or Oakland or Rancho Cordova or Redding or San Diego or Woodland Hills
$34-$51/hr HybridFull Time
Ascendiun
Ascendiun: Nonprofit parent overseeing health insurance and clinical service organizations.
3+ YOECurrent California LVN license, vocational nursing certificate or diploma, and 3 years of auditing experience in utilization management or outpatient authorization review; requires strong communication and computer skills.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, CMS, DMHC, DHCS, NCQA
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1w
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CEQA - Senior Project Manager
Sacramento County or San Francisco or Los Angeles
$10k-$12k/mo HybridFull Time
State Controller's Office
State Controller's Office: California's fiscal controller managing state financial operations and assets.
Experience managing CEQA/NEPA reviews and complex infrastructure or telecommunications projects; must meet eligibility for the Public Utilities Regulatory Analyst V classification and submit required application materials.
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6d
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Case Manager II - FT Days
San Francisco, California, United States
$65-$82/hr OnsiteFull Time
ScionHealth
ScionHealth: Operates community and specialty hospitals providing acute healthcare services.
2+ YOEHealthcare professional licensure as an RN, LCSW, or LSW; accredited program graduate; two years of healthcare experience preferred. Case management, utilization review, or discharge planning experience preferred.
Microsoft Office
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1mo
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Case Manager (RN) - Inpatient - 1.0 FTE, 08-HR, Day Shift
Palo Alto, California, United States
$96-$111/hr OnsiteFull Time
Stanford Health Care
Stanford Health Care: Provides comprehensive medical care, specialized treatments, and clinical research.
3+ YOECA RN license required, Bachelor's degree required (Master's preferred), 3 years related experience, expertise in discharge planning, utilization review, care coordination, and third-party reimbursement.
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3w
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Behavioral Health Medical Director – Psychiatrist – California Medicaid (Part-Time)
Costa Mesa or Woodland Hills or Walnut Creek or Palo Alto
$178k-$290k/yr HybridPart Time
Elevance Health
Elevance HealthNYSE: ELV: Provides health insurance plans and integrated healthcare services.
10+ YOEMD/DO, active California medical license, board certification, minimum 10 years clinical experience, experience in behavioral health, ability to conduct utilization management reviews and provide clinical leadership.
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2w
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Patient Navigator 2
San Francisco, California, United States
$67k-$108k/yr OnsiteFull Time
University of California, San Francisco
University of California, San Francisco: Public research university dedicated to health sciences and education.
1+ YOEFlexibility to work at all UCSF Medical Center locations; 1 year related experience; bachelor’s degree preferred or equivalent experience/training; experience with insurance authorization, patient registration, and utilization review.
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3mo
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CLINICAL CARE COORDINATOR
San Francisco, California, United States
$30-$35/hr OnsiteFull Time
Universal Health Services
Universal Health ServicesNYSE: UHS: Operates acute care hospitals and behavioral health facilities.
High School Diploma or GED; associate or bachelor’s preferred; RADC/CADC/CATC/SUDCC; experience with dual diagnosis, case management, and utilization reviews; licensure preferred; strong computer skills with multiple systems.
Electronic Health Records, Billing software MS4, TimeTap, Midas, Microsoft Word, Microsoft Excel, Microsoft Outlook, Windows, Tier & Athena
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3w
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Case Manager - Physical Rehabilitation
San Francisco, California, United States
OnsiteFull Time
UCSF Health
UCSF Health: Academic medical center providing advanced patient care and research.
Provides case management and complex discharge planning for a designated caseload; requires bachelor\u0002s in healthcare, RN license in California, BLS, case management/utilization review experience, EMR proficiency, strong communication and analytic skills.
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1w
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Senior Technical Sales Engineer – eBOS
Fremont or California
$155k-$165k/yr HybridFull Time
Nextpower
NextpowerNasdaq: NXT: Provides integrated solar tracker and energy technology solutions.
8+ YOERequires 8+ years in utility-scale solar, technical sales engineering, applications engineering, system design, or construction; advanced Excel, Salesforce or equivalent CRM, U.S. sales, IE reviews, and lender technical diligence experience.
Microsoft Excel, Salesforce
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1mo
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Facility Electrical Assessment Consultant 1
Overland Park or Cary or Houston or Orlando or Charlotte or Dallas or Tualatin or Atlanta or Austin or Phoenix or Tampa or Gaithersburg or Bloomington or Chicago or Denver or Kansas City or Walnut Creek or Olathe
HybridFull Time
Black & Veatch
Black & Veatch: Provides engineering, procurement, and construction services for global infrastructure.
4+ YOEDevelop and perform electrical asset assessments and inspections for water, wastewater, power and utility facilities; review test results and prepare technical reports; 4+ years consulting experience preferred; bachelor’s in electrical engineering preferred; knowledge of FERC, IEEE, NEC.
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