- 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
- CenterWell (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
- Dignity Health (Woodland, CA)
- …with the RN Care Coordinator to coordinate care plans based on the utilization review activities performed by the RN Care Coordinator with compliance of ... a non-benefitted, on-call position. The role will be hybrid, with possible remote option, after initial onsite training.** **This position provides the clinical… more