- CVS Health (Sacramento, CA)
- …in state of residence + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS ... And we do it all with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs)… more
- Fresenius Medical Center (Rancho Cucamonga, CA)
- …related field preferred or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality ... Remote role with up to 60% travel **PURPOSE...to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to determine medical necessity… more
- Amergis (Orange, CA)
- …help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing requests for ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Parexel (San Francisco, CA)
- **Job Title:** Data Management Lead (Medical Affairs) **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At Parexel, ... practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable...ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or… more
- Dignity Health (Woodland, CA)
- …RN Care Coordinator to coordinate care plans based on the utilization review activities performed by the RN Care Coordinator with compliance of federal ... a non-benefitted, on-call position. The role will be hybrid, with possible remote option, after initial onsite training.** **This position provides the clinical… more