- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day shifts.** ... and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by… more
- Gilead Sciences, Inc. (Foster City, CA)
- …change over time, our initial need is for an expert in Material Review platforms (Veeva MedInquiry, VeevaVault, MedDocs, etc). Responsibilities include but are not ... + Hands on experience administering and deploying platforms for Material Review (Veeva MedInquiry, VeevaVault, MedDocs) preferred. + Additional certifications in… more
- Evolent (Sacramento, CA)
- …for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact ... interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better… more
- CVS Health (Sacramento, CA)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical ... consists of working intensely as a telephonic Associate Manager, Case Management with staff and clients for fully and/or...a potential quality of care issue to a physician reviewer . - Identify and address quality issues and participates… more
- Actalent (Sacramento, CA)
- …representatives + Conduct in-person hospital rounds 2-3 days per week, telephonic review and participate in interdisciplinary case reviews + Escalate complex ... cases to the Vivant Health Medical Director or Physician Reviewer + Ensure complete, accurate, and compliant documentation in...+ At least 1 year of experience in utilization review , case management, or hospital discharge planning… more
- Prime Healthcare (Ontario, CA)
- …license. + Minimum (2) two years of experience in acute hospital case management or equivalent. + Utilization Management experience required. + Excellent ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/utilization- review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Amergis (Orange, CA)
- Amergis Healthcare is seeking a highly motivated an experienced LMFT/LCSW Medical Case Manager to help support a health insurance agency! The Medical Case ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Prime Healthcare (Chula Vista, CA)
- …Responsibilities Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case ... assist with development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state… more
- Prime Healthcare (San Dimas, CA)
- …focused. Responsibilities Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case ... Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and files them accordingly or as per facility's procedure. Assists… more
- Prime Healthcare (La Palma, CA)
- …Responsibilities Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case ... assist with development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state… more