2mo
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Utilization Specialist PRN
Riverside, California, United States
$31-$50/hr OnsiteAll Commitments Available
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
3w
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Utilization Analyst PT36 Nights
Downey, California, United States
$31-$33/hr OnsitePart Time
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.
Health Connect, Mainframe
1w
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Utilization Clerk
Corona, California, United States
$23-$26/hr HybridFull Time
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
1w
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Coordinator II, Utilization Management
Montebello, California, United States
$27-$34/hr HybridFull Time
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.
6d
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Utilization Management Authorization Assistant
Redlands, California, United States
$23-$29/hr OnsiteFull Time
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.
5d
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Utilization Review Tech
Santa Ana, California, United States
$25-$37/hr OnsiteFull Time
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
3w
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Utilization Review Coordinator
Long Beach, California, United States
$26-$28/hr OnsiteFull Time
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
2mo
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Utilization Management Clinical Trainer (Hybrid Remote)
Orange or United States
$78k-$117k/yr HybridFull Time
5+ YOE5+ years nursing in managed care/utilization review; RN or LPN license; Bachelor’s in Nursing/Health or Education; experience in clinical training.
6d
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Medical Director Utilization Management Oncology
Cerritos or California or Nevada or Arizona or Oregon or Florida
$275k-$325k/yr RemoteFull Time
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.
1w
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Manager, Behavioral Health Utilization Management
El Dorado Hills or California or Long Beach or Lodi or Oakland or Rancho Cordova or Redding or San Diego or Woodland Hills
$112k-$167k/yr HybridFull Time
7+ YOE3+ MgmtCurrent unrestricted CA LMFT, LCSW, LPCC, PhD/PsyD or RN license; doctoral/master/associate degree requirements by license; 7+ years relevant experience; 3 years management; utilization management experience preferred.
2mo
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Utilization Review (UR) Assistant
Long Beach, California, United States
$21-$26/hr OnsiteFull Time
1+ YOEHigh School graduate or GED preferred; 1 year acute care/hospital experience preferred; medical terminology knowledge required.
1mo
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Utilization Review Supervisor RN
Rancho Cucamonga, California, United States
$78k-$120k/yr RemoteFull Time
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
1w
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(RN) Manager - Utilization Management - 140306
San Diego, California, United States
$133k-$260k/yr HybridFull Time
5+ YOEBachelor's in nursing, active California RN, 5+ years relevant experience including IPA/MSO or Health Plan/HMO experience, prior authorization and UM knowledge, supervisory experience, strong communication and analytical skills.
MCG, Epic, EPC
1mo
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Utilization Review Case Manager
San Juan Capistrano, California, United States
$30-$35/hr OnsiteFull Time
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
2w
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Utility Worker I/II
Rancho Santa Fe, California, United States
$68k-$103k/yr OnsiteFull Time
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).
2d
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Discharge Planner - Utilization Management
Montclair, California, United States
$23/hr OnsiteFull Time
Knowledge of discharge planning/utilization/case management, high school diploma, basic-intermediate computer skills, current BCLS required; hospital experience preferred.
1d
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Discharge Planner - Utilization Management
Montclair, California, United States
$23/hr OnsiteFull Time
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.
1w
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WATER TREATMENT PLANT OPERATOR I
Rancho Cucamonga, California, United States
$7k-$9k/mo OnsiteFull Time
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
1mo
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Registered Nurse - Utilization and Care Transitions
Riverside, California, United States
$50-$75/hr OnsiteFull Time
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.
EMR
4w
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Medical Case Manager, BHI Utilization Management - Covered California
Orange or California
$91k-$145k/yr RemoteFull Time
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
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