- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of… more
- PennyMac (Moorpark, CA)
- …mortgage journey. A Typical Day Position Summary:The Operations Manager - Precision Review at PennyMac will lead and oversee a specialized team responsible for ... improvement, and team development, driving efficiency and accuracy across the Precision Review function. The Operations Manager will serve as a key partner to… more
- Deloitte (Los Angeles, CA)
- …facts patterns and laws, regulations, cases and administrative guidance. + Comprehensive review of information to understand a Client's business and its tax returns. ... up of multiple tax service offerings including Strategic Tax Review , Inventory Tax Services, and Meals & Entertainment ...Review , Inventory Tax Services, and Meals & Entertainment Review Services, among others. Each NFTS service offering has… more
- Molina Healthcare (San Diego, CA)
- …JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Molina Healthcare (San Diego, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 NIGHT SHIFT 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Dignity Health (Rancho Cordova, CA)
- …from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN, you will use clinical judgement in providing utilization management ... position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may include: - Conducts… more
- Molina Healthcare (Long Beach, CA)
- …JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... health care experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (CA)
- …JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Emanate Health (Covina, CA)
- …the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
- Prime Healthcare (Lynwood, CA)
- …effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn-case-manager utilization- review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Francis Medical… more