- The County of Los Angeles (Los Angeles, CA)
- …stooping, or squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...Nurse ? In the County of Los Angeles, a Utilization Review Nurse is an RN… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested… more
- John Muir Health (Walnut Creek, CA)
- …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + ... case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the...this in coordination with the interdisciplinary health team. The RN Case Manager is expected to function within the… more
- The County of Los Angeles (Los Angeles, CA)
- …AED) Programs. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...in a state other than California must provide their Registered Nurse License Number from that state… more
- Alameda Health System (Oakland, CA)
- …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 +… more
- Alameda Health System (San Leandro, CA)
- …the Emergency Department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia.\ Pay Range $89.32- ... Clinical Nurse III, Acute Inpatient Behavioral Health Utilization...Medi-Cal and/or commercial insurances and ensures the patient is registered at the appropriate level of care. 3. Communicates… more
- TEKsystems (Los Angeles, CA)
- …for a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) with hands-on experience in Utilization Management (UM) and a strong understanding of ... Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is responsible for… more
- CVS Health (Sacramento, CA)
- …And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in ... is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize...management function. **Required Qualifications** -Must reside in PST zone. - RN with active and unrestricted state licensure in state… more
- Prime Healthcare (Inglewood, CA)
- …outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered ... of Case Management to lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers, and Clinical Coordinators. This leader will oversee all… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role...to case management as appropriate Qualifications + Active CA RN license in good standing + 2-3 years of ... We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care from a fully remote environment. This… more