- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …CA Salary Range $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed nursing professional ... Nurse will also work with the MSO Case Management team on coordinating patient care to ensure patients...to solve the complex issues. Collaborates with MSO Case Management team and PCPs to ensure resource utilization… more
- Pair Team (Livermore, CA)
- …of whole-health care that Pair Team can provide. This position primarily allows for remote work; however, it includes 1-2 times a month on-site visits in the ... home What You'll Do Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health… more
- UHS (Corona, CA)
- …www.swhealthcaresystem.com . Job Summary: Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist. Duties include but not ... and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services.Responsible for improving the overall… more
- Talent Connect Now (San Diego, CA)
- …delivery of participant care (resources), clinical outcomes, performance improvement, and Utilization Management (UM). Designs and conducts quality projects and ... and resource to the Primary Care Physician, on-call physicians, and Nurse Practitioners. The Medical Director also interfaces and collaborates with specialist… more
- myPlace Health (Los Angeles, CA)
- …needs, in collaboration with participants, families, and the myPlace interdisciplinary team. Utilization and Care Management : Work closely with the Medical ... proactively intervene to prevent complications or readmissions. Complex Case Management : Identify high-risk cases, anticipate potential challenges, and implement… more
- International SOS Government Medical Services (San Diego, CA)
- Company Description International SOS delivers customized medical and security risk management and wellbeing solutions to enable our clients to operate safely and ... and operation of healthcare solutions including freestanding surgical facilities in remote and austere environments, telemedicine consultation through a wide range… more
- CVS Health (Sacramento, CA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... and every day. **Position Summary** This is a fully remote role open to candidates with an active RN...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
- Sharecare (Sacramento, CA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Molina Healthcare (Oakland, CA)
- …Preservice and outpatient experience. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of the… more
- Centene Corporation (Sacramento, CA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
