- Magellan Health Services (San Diego, CA)
- …Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... This is a remote position in California, candidates must be licensed...activities of assigned care support teams. Experience with Care Management flows. Knowledge of utilization management… more
- Stanford Health Care (Palo Alto, CA)
- …active: + CCDS - Cert Clinical Document Spec . + CCDS-O or CDIP . + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... + ICU/ED and Academic Medical Center experience preferred. + Case management , utilization review and/or direct provider interaction experience, preferred.… 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. ... agreement. Preservice and outpatient experience. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
- Dignity Health (Bakersfield, CA)
- … experience). - Bachelor's degree in Nursing, Social Work or equivalent experience - Active Registered Nurse ( RN ) or Social Worker (SW) license in good ... **Responsibilities** This position is remote .** **Position Summary:** This position will act as...and education resource; staff and leadership development consultant; and Utilization Management content expert for staff, leaders,… more
- CVS Health (Sacramento, CA)
- …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS Office + Must be willing ... with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may...The Associate Manager is also responsible for oversight of utilization management nurses including the organization and… more
- CommonSpirit Health (Rancho Cordova, CA)
- …large multi-hospital system + 10+ years overall care coordination experience + Current Registered Nurse ( RN ) license. **Overview** Inspired by faith. Driven ... SanFrancisco, Santa Cruz and Redwood City** **This is a remote position however the incumbent must reside in the...markets in a region. Oversees the centralized functions of Utilization Management Services, including but not limited… 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
- 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 ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
- Humana (Sacramento, CA)
- …provider population health programs focused on Stars, HEDIS, MRA, chronic condition management , and other efforts to reduce avoidable utilization * Supporting ... supporting provider performance, and coordinating with cross-functional teams to drive quality, utilization , and cost-of-care outcomes. At the core, this is a role… more
- Amergis (Orange, CA)
- …to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and processing requests for ... related processes. Position Details: Location: Orange (Full Office, no remote !) Schedule: 40 hours a week, 8 AM to...listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care… more