- Cognizant (Sacramento, CA)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Elevance Health (Los Angeles, CA)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Elevance Health (Los Angeles, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... to 5:05 PM Pacific. Training hours may vary. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- CVS Health (Sacramento, CA)
- …+ Direct clinical experience in a hospital setting or prior Utilization Management experience. + Valid California unrestricted independent professional ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program for preauthorization for mental health services.… more
- Humana (Sacramento, CA)
- …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and… more
- Prime Healthcare (Anaheim, CA)
- …Bachelor degree in a related field or at least one year experience in case management , discharge planning or nursing management ; 2. Experience and knowledge ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230272/case-manager utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityWest… more
- Prime Healthcare (San Dimas, CA)
- …care nursing experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS ... 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Insight Global (Campbell, CA)
- …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Medi-Cal HMO lines of business - Health plan experience - Prior experience working with health plan portals more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually Location Ventura and Santa Paula, CA Job Type Full-Time Regular… more