- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- CVS Health (Sacramento, CA)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant... function. **Required Qualifications** -Must reside in PST zone. - RN with active and unrestricted state licensure in state… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership in a professional organization.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse ( RN ) - CA Board of Registered ... or clinical experience in area of specialty. + California Registered Nurse ( RN ) - CA...and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for… more
- Cognizant (Sacramento, CA)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- John Muir Health (Walnut Creek, CA)
- …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + BLS ... the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** +… more
- Providence (Irvine, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** ** RN Utilization Review at Irvine, CA....Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience… more