- Centene Corporation (Sacramento, CA)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Emanate Health (Covina, CA)
- …the United States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... Education Requirement:** **Minimum Experience Requirement:** Minimum of three years of utilization management experience. Experience in quality- related job… more
- Elevance Health (Walnut Creek, CA)
- …precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer . + Responsible for the ... ** Utilization Management Representative I** **Location:** Virtual:...responsible for coordinating cases for precertification and prior authorization review . **How will you make an impact:** + Managing… more
- Baylor Scott & White Health (Sacramento, CA)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for medical necessity ... to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care.… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… 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 patiens… more
- Prime Healthcare (Chino, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/219949/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top...community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Prime Healthcare (San Dimas, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Centene Corporation (Sacramento, CA)
- …offering competitive benefits including a fresh perspective on workplace flexibility. **Concurrent Review Nurse - Remote (California Market | Health Net)** ... Centene is seeking a **Remote Concurrent Review Nurse ** to support our **Health Net...2 years in acute care and managed care, with utilization management experience This is a great… more