- CVS Health (Sacramento, CA)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Cognizant (Sacramento, CA)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review , membership in a professional… more
- Cedars-Sinai (Los Angeles, CA)
- …has named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & ... Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager... Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Reviewer I** **Location:** This role...hospital setting or minimum of 1 year of prior utilization management , medical management and/or ... Monday - Friday (9:30 AM -6:00 PM Centeral) The ** Nurse Reviewer I** is responsible for conducting...required. **Preferred Skills, Capabilities and Experiences:** + Familiarity with Utilization Management Guidelines is preferred + ICD-9… more
- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management , and quality improvement functions to ensure ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)..., Disease Management , Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must… more
- Cedars-Sinai (Los Angeles, CA)
- …necessity reviews with accepted criteria required **Req ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 ... **What will you be doing in this role?** The Utilization Review Case Manager validates the patient's...Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more