- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333)...needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review… more
- Molina Healthcare (Long Beach, CA)
- …clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required License, Certification, Association** Active, ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...of proactive approaches to improve and standardize overall retrospective claims review . * Ensures core system is… more
- Travelers Insurance Company (Walnut Creek, CA)
- …Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality ... negotiating and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Lincoln Financial (Sacramento, CA)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... will act as a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information to clarify diagnoses,… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical … more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …For more information, refer to Required Documents below. The Jennifer Moreno DVA Medical Center in beautiful San Diego, California is looking to hire an Associate ... State Veterans Home Liaison, Administrative Assistant, Administrative staff for review of eligibility, authorizations and scheduling etc., Registered Nurses (RNs)… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE I/RELIEF NURSE Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3394509) Apply REGISTERED NURSE I/RELIEF NURSE ... Date 02/07/2022 + Description + Benefits + Questions Position/Program Information REGISTERED NURSE I: $8,006.34 - $11,984.48 MONTHLY RELIEF NURSE : $57.41 to… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE I, SHERIFF (CORRECTIONAL HEALTH) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2930992) Apply REGISTERED NURSE I, ... of Los Angeles is currently offering up to 20% bonus for full-time Registered Nurse I, Sheriff positions hired by Correctional Health Services and working on-site in… more
- CVS Health (Sacramento, CA)
- …in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.… more