- Sutter Health (Roseville, CA)
- …Sutter Health philosophies and initiatives. Participates as a member of the utilization Management Committee (UMC). **Job Shift:** Days **Schedule:** Full Time ... well as patients and their families. **Job Description** : **EDUCATION:** + Master's: Nursing , Case Management , or Social Work **CERTIFICATION & LICENSURE:** +… more
- Highmark Health (Sacramento, CA)
- … **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Sutter Health (Jackson, CA)
- …Health! **Organization:** SAH-Sutter Amador Hospital **Position Overview:** Coordinates the utilization management , resource management , discharge planning, ... needs. **Job Description** : **EDUCATION:** + Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California +… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- … nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients...managed care, utilization management , discharges planning, and continuous quality… more
- Highmark Health (Sacramento, CA)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... Documents, processes and routes requests for services to the nurse reviewer and other departments based on documentation procedures,...and management . + Route Cases Based on Established Guidelines. +… more
- Evolent (Sacramento, CA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- Sutter Health (San Francisco, CA)
- …Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The ... has frequent contact with patients, families, physicians, the interdisciplinary team, nursing management , quality, ancillary services, third party payers and… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an… more
- CVS Health (Sacramento, CA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Trinity Health (Fresno, CA)
- …the acute care continuum for CVHP members. This includes discharge planning, utilization management , care coordination, and support for resource utilization ... an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. The incumbent makes significant contributions toward… more
Recent Jobs
-
Diagnostic Technologist
- UPMC (Jamestown, NY)
-
Clinic RN - Swedish Float Pool
- Swedish Health Services (Renton, WA)
-
Client Services Representative II - Preferred Deposits - 1st Shift - East Providence
- Bank of America (Riverside, RI)
-
Nurse Tech Surgical ICU
- Corewell Health (Grand Rapids, MI)