- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:...clinical unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for… more
- Sacramento County (Sacramento, CA)
- …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...improperly rejected may request the Employment Services Division to review its decision to reject the application. If the… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… more
- Cognizant (Sacramento, CA)
- …expectations. **What you need to have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines… more
- Cedars-Sinai (Beverly Hills, CA)
- …Angeles Fair Chance Initiative for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator - PER_DIEM 8 Hour Days **Department** ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers. Review all cases… more
- University of Southern California (Arcadia, CA)
- …cost per case, excess days, resource utilization, readmission rates, denials, and appeals . + Collaborates and communicates with multidisciplinary team in all phases ... continuous improvement in both areas. + Perform 100% UR Review on all Medicare One-Day admissions. + Proactively identifies.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
- Sacramento County (Sacramento, CA)
- …of Supervising Public Health Nurse : + Must possess and maintain a current Registered Nurse License and Public Health Nurse Certificate issued by the ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...to this class must possess and maintain a current Registered Nurse license and Public Health … more
- Sharp HealthCare (San Diego, CA)
- …+ 3 Years case management, utilization review , care coordination experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers. Review all cases… more