- Sharecare (Sacramento, CA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Molina Healthcare (Oakland, CA)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager ... (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- Alameda Health System (Alameda, CA)
- …and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited ... as required by OBRA and PPS. 3. Assists Case Manager with the transfer of patients to other health...assessments. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- Elevance Health (Walnut Creek, CA)
- ** Nurse Reviewer I** Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... to work weekends if necessary. New Grads are encouraged to apply! The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out of network and… more
- Amergis (Orange, CA)
- … Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- e CancerCare (Fresno, CA)
- …the creation and execution of the clinical trial development strategy, study contract review , study budget review , negotiation, and in consultation with the ... including Research Nurses, Clinical Research Coordinators, Regulatory Coordinators, Research Manager , and other support staff; coordinates quality and customer… more
- Elevance Health (Costa Mesa, CA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... 5pm PST, this position includes weekends. The Med Mgmt Nurse is responsible for review of the...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more