- CVS Health (Sacramento, CA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- CVS Health (Sacramento, CA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
- CenterWell (Sacramento, CA)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Sacramento, CA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- CVS Health (Sacramento, CA)
- …+ Direct clinical experience in a hospital setting or prior Utilization Management experience. + Valid California unrestricted independent professional ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program for preauthorization for mental health services.… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure and/or Compact ... This is a hybrid role having a combination of remote and onsite as scheduled. Whether this would be...as scheduled. Whether this would be your first case management role or you are seasoned, here is your… more
- Sharp HealthCare (San Diego, CA)
- …BBS Licensed Marriage and Family Therapist (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Shift **Additional Shift Information:** starts between 6:30 and 8:30am ( remote work not available) **Weekend Requirements:** No Weekends **On-Call...(AHA BLS Healthcare) - American Heart Association + California Registered Nurse ( RN ) - CA… more
- Actalent (Sacramento, CA)
- Registered Nurse - Case Management ...the established plan of patient care and ensuring effective management of visit utilization and control of ... Job Description We are seeking a Registered Nurse Case Manger to join our Senior Care team...systems in California! Responsibilities + responsible for the overall management of patients, including the provision of direct care… more
- Magellan Health Services (San Diego, CA)
- …- Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community… more
- Sharecare (Sacramento, CA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more