- CenterWell (Sacramento, CA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… 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
- Prime Healthcare (San Dimas, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan… more
- CVS Health (Sacramento, CA)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- Providence (Napa, CA)
- …in an inpatient or outpatient case management setting + Upon hire: California Registered Nurse License + 2 years Case management , discharge planning, or ... **Description** Care Manager RN - Utilization Review unit at... of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse - Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position ... of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted… more
- Sutter Health (Roseville, CA)
- …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... SMCS-Valley Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted… more
- Sutter Health (Tracy, CA)
- …+ Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... **Organization:** STCH-Sutter Tracy Community Hosp **Position Overview:** Coordinates the utilization management , resource management , discharge planning,… more
- CVS Health (Sacramento, CA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more