- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- CVS Health (Sacramento, CA)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... 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… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review ,...Department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia.\ Pay… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management , and concurrent review ... at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management...following major functions: + Pre-service Authorizations/Denial Letters + Concurrent Review + Continuity of Care + Retro Claims +… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
- Cognizant (Sacramento, CA)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Cedars-Sinai (Los Angeles, CA)
- …reviews with accepted criteria required **Req ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour ... **What will you be doing in this role?** The Utilization Review Case Manager validates the patient's...Association or American Red Cross required + Certified Case Management RN preferred **Experience:** + A minimum… more
- Cedars-Sinai (Los Angeles, CA)
- …one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent ... Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review... Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Providence (Irvine, CA)
- **Description** ** RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, ... Management , medical necessity, and patient status determination. The Utilization Management RN must effectively...Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience… more