- Centene Corporation (Sacramento, CA)
- …Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health ... care issues, and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare providers,… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a ** Nurse Practitioner** for a full-time position supporting the **Pain Management Clinic** at **Camp Pendleton, ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Sharecare (Sacramento, CA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- LA Care Health Plan (Los Angeles, CA)
- …adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert ... Registered Nurse - Payment Integrity Nurse Coder...inpatient, outpatient, and professional claims. Serves cross functionally with Utilization Management , Medical Directors, and other internal… more
- The County of Los Angeles (Los Angeles, CA)
- …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... an individual's ability to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience,… more
- The County of Los Angeles (Los Angeles, CA)
- …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... Administration + Nursing Education + Health Science + Healthcare Management + Healthcare Education + Healthcare Administration + Public...to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your… more
- The County of Los Angeles (Los Angeles, CA)
- …an individual's ability to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience, ... NURSE PRACTITIONER- PEDIATRIC HUB CLINICS/NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2588395) Apply NURSE PRACTITIONER-… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …RN possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation ... evidence-based-practice culture. Preferred Experience: 5 years of current registered nurse experience Case Management /Discharge Planner experience PACT… more
- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... Mental Health Nurse - Hospital Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4964847) Apply Mental Health Nurse - Hospital Salary… more
- Sutter Health (Roseville, CA)
- …SMCS-Valley Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more