- CVS Health (Sacramento, CA)
- …(RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active ... each and every day. **Schedule is Monday - Friday 8am-5pm est.** No travel required. Non-exempt. Hourly. Pay: Bi-weekly. No shift premium. Occasional Overtime may be… more
- CenterWell (Sacramento, CA)
- …Conviva Senior Primary Care's) highest need and complexity patients with care and case management services. The Director is response for the strategic direction, ... quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's...Risk Patient Management Program - Care and case management interdisciplinary offering for top 5%… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Bachelor's Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management , or Quality Management ... Management program that includes initial and concurrent review; case management /discharge planning activities. Responsible for operational planning… more
- Global Foundries (Santa Clara, CA)
- …Years of Relevant Experience + Prior Experience in Photonics and Photonics Packaging. + Travel - 10-20% of time + Language Fluency - English (Written & Verbal) ... Preferred Qualifications: + Project management skills - ie, the ability to innovate and...information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Ventura County (Ventura, CA)
- …their families in collaboration with other members of the mental health team. + Case Management : + provides case management /brokerage including linkage ... - $80,267.20 Annually Location and may be required to travel throughout Ventura County, CA Job Type Full-Time Regular...Utilization review: + Uses professional skills in quality management activities such as utilization review, monitoring… more
- Actalent (Sacramento, CA)
- …experience (eg, med-surg, telemetry, ICU). + At least 1 year of experience in utilization review, case management , or hospital discharge planning preferred + ... Utilization Review Nurse (LVN) - InpatientPrimary Responsibilities +...medical necessity. + Collaborate with hospital teams, providers, IPA case managers, and health plan representatives. + Conduct in-person… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Highmark Health (Sacramento, CA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more