- Providence (Irvine, CA)
- **Description** **RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, retrospective, ... strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role...2-3 years of clinical experience in prior authorization, case management , or utilization management + ... We're looking for a Utilization Review (UR) Nurse to join our...obtain additional clinical information when needed + Support denial management , including appeals and peer‑to‑peer review processes… more
- Dignity Health (Rancho Cordova, CA)
- …position is work from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN, you will use clinical judgement in providing ... utilization management (UM) services. The focus is...assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may… more
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent ... **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager - 8 Hour... Case Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- TEKsystems (Los Angeles, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims ... Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation: LVN...RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Prime Healthcare (Sherman Oaks, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case-manager- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Team of Dedicated Healthcare Workers Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/ utilization - review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... (2) two years of experience in acute hospital case management or equivalent. + Utilization Management...acute hospital case management or equivalent. + Utilization Management experience required. + Excellent interpersonal… more