- CVS Health (Sacramento, CA)
- …work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review or prior ... thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their...+ 1 year of varied UM ( utilization management ) experience within an inpatient, concurrent review … more
- 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 ... procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to… more
- CenterWell (Sacramento, CA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management ...as needed to assist with patient care coordination and utilization review . The incumbent will be responsible… more
- Evolent (Sacramento, CA)
- …As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Evolent (Sacramento, CA)
- …As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As ... #:42003-31126 + FTE:0.01 + Posted:Today **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
- Providence (Napa, CA)
- …+ Upon hire: California Registered Nurse License + 2 years Case management , discharge planning, or utilization management experience in the acute, ... **Description** Care Manager RN - Utilization Review unit at Providence Queen... of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease… more