- Cognizant (Sacramento, CA)
- …cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews . ... have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical ...stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... (A&G) & General Operations ( Clinical ) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals & Grievances… more
- Elevance Health (Los Angeles, CA)
- …set of clinical domains, including radiology, cardiology and oncology. The ** Appeals Nurse Reviewer I** is responsible for conducting preauthorization, out ... ** Appeals Nurse Reviewer I** **Location:** This...reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. **How you will make an… more
- City and County of San Francisco (San Francisco, CA)
- …assists with designing and implementing plans for meeting such needs. The Clinical Nurse Specialist performs other related duties as assigned/required. Minimum ... by the California Board of Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Stanford Health Care (Palo Alto, CA)
- …role in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position ... regulations, payor policies, and industry best practices related to clinical appeals and denials management. Evaluate internal...required within 180 Days or + RN - Registered Nurse - State Licensure And/Or Compact State Licensure required… more
- City and County of San Francisco (San Francisco, CA)
- …other members of the multidisciplinary health care team and performs specialized nurse practitioner duties in clinical settings. The essential functions include, ... [REF56288W] Note: If you previously applied to a DPH Nurse Practitioner position before 9/26/25, you need to apply...and manages patients with unstable chronic diseases appropriate to clinical specialty. + Provides urgent care to acutely ill… more
- Sacramento County (Sacramento, CA)
- Nurse Practitioner Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1780920) Apply Nurse Practitioner Salary $132,483.60 - $161,026.56 ... 9/26/2025, 10/24/2025, 11/26/25, 12/26/25, 1/23/26, 2/27/26, 3/27/26, 4/24/26, 5/22/26, 6/26/26 Nurse Practitioners provide a range of health care services involving… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 7/2/2026, 10/2/2026 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 5/8/2025, 7/3/2025, 9/4/2025, 11/6/2025 Registered Nurse D/CF Level I: $61.27 - $74.48 hourly Registered...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- CVS Health (CA)
- …Managers, Manager, and other key stakeholders such as Medical Directors, account teams/ clinical liaisons, etc.) to ensure consistency in clinical interventions ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory...+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience +… more