RN Utilization Manager - Bakersfield, CA

The RN Utilization Manager is responsible for reviewing and coordinating healthcare service requests to ensure they meet clinical and regulatory standards. · Evaluating medical necessity of referrals and authorizations. · Applying clinical guidelines (e.g., Medicaid, Milliman cri ...

· Responsible for written and verbal communication with contract providers and internal staff to promote timely coordination of care and dissemination of policies and procedures. · Collaborates with the Member Service Department and the Provider Relations Department regarding qu ...

Responsible for written and verbal communication with contract providers and internal staff to promote timely coordination of care and dissemination of policies and procedures. · Collaborates with the Member Service Department and the Provider Relations Department regarding quali ...

As the Utilization Management (UM) Physician Reviewer, · ...

Job Summary And Responsibilities · As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. Thi ...

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. The reviewer will engage in peer-to-pe ...

*Job Summary and Responsibilities* · As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. T ...

· Where You'll Work · Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they w ...

About The Role · We're looking for an RN who enjoys using their clinical judgment · without bedside stress · . In this role, you'll review outpatient and home‑based service requests—such as DME, home health, therapies, and procedures—to help determine medical necessity and ensure ...

· Company Description · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest a ...

About the Role · We're looking for an RN who enjoys using their clinical judgment without bedside stress. In this role, you'll review outpatient and home‑based service requests—such as DME, home health, therapies, and procedures—to help determine medical necessity and ensure our ...

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. · ...

The UM Clinical Manager is responsible for reviewing Utilization Management policy and guidelines to ensure staff compliance with policies. · Perform audits on various project reports, Notice of Action notifications, and referrals for compliance. · ...

The Senior Project Manager is responsible for the overall management of construction project resulting in successful project completion. · ...

The Assistant Project Manager is responsible for the administration of the construction project, · assisting the Project Manager in management of the construction project. · This position will be based onsite in California or Nevada.Employees (and their families) are eligible for ...

We are seeking a travel nurse RN Case Manager for a challenging opportunity in California. · Job Requirements · Case Management experience required. · RN licensure and 2+ years of acute care hospital experience necessary. · Familiarity with utilization review, discharge planning ...

Voca Healthcare is seeking a travel nurse RN Case Management for various locations. Key details include: · • Specialty: Case Management · • Discipline: RN · About the Role · Duties include coordination and facilitation of care to ensure optimal patient outcomes. · Candidates mus ...

Coast Medical Service is seeking a travel nurse RN Case Management for a travel nursing job in Bakersfield, California. · Job Description & Requirements · Specialty: · Case Management · Discipline: · RN · Start Date: · 03/23/2026 · Duration: · 13 weeks · 40 hours per week · Shift ...

TNAA TotalMed RN is seeking a travel nurse RN Case Management for a travel nursing job in Bakersfield, California. · Job Description & Requirements · Specialty: · Case Management · Discipline: · RN · Start Date: · 03/23/2026 · Duration: · 13 weeks · 40 hours per week · Shift: · 8 ...

Travel Nurse RN Case Management Job · Host Healthcare is seeking a travel nurse RN Case Manager to join our team. We provide a comfortable experience for nurses exploring their career through travel nursing, therapy, or allied healthcare. · Job Details: · • · Specialty: · Case Ma ...