- Dignity Health (Bakersfield, CA)
- …to patient information, PHI and HIPAA regulations. **Preferred Qualifications:** - Prior Utilization Management (UM) experience strongly preferred. - Bachelor's ... as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse… more
- Evolent (Sacramento, CA)
- …and stakeholders. + Familiarity with healthcare claims, reimbursement methodologies, and cost/ utilization KPIs, including prior authorization data and key ... : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population health opportunities using SAS, SQL, Excel, and Power… more
- Dignity Health (Bakersfield, CA)
- …to patient information, PHI and HIPAA regulations. **Preferred Qualifications:** - Prior Utilization Management (UM) experience strongly preferred. - Bachelor's ... as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location...Must possess a valid Basic Life Support (BLS/CPR) Certificate PRIOR to the first day of employment. *These competency… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR ... service are met and is subject to closure without prior notice. ABOUT LOS ANGELES COUNTY DEPARTMENT OF HEALTH...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,… more
- CVS Health (Sacramento, CA)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... 4 hours a day working with providers to secure additional information for prior authorization review. + This candidate will utilize clinical skills to coordinate,… more
- Actalent (Redlands, CA)
- Job Title: Remote LVN Case Manager - Utilization Management Job Description Join our dynamic Utilization Management team as an LVN Case Manager where you will ... with internal staff to ensure seamless care coordination. Essential Skills + Utilization review and management experience. + Familiarity with Medicare, MediCal, and… more
- Actalent (Santa Barbara, CA)
- Utilization Management Nurse (RN) - Santa Barbara, CA Hourly Rate: $50-$53/hr Location: On-site in Santa Barbara, CA Schedule: Full-time, Monday-Friday (no weekends ... a detail-oriented and compassionate Registered Nurse to join a high-performing Utilization Management team supporting outpatient specialty care. This role is ideal… more
- Centene Corporation (Sacramento, CA)
- …(BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH to determine medical appropriateness in ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...to members and their families regrading ABA and BH utilization process + Provides feedback to leadership on opportunities… more
- Prime Healthcare (Inglewood, CA)
- …and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patiens receive ... case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Additionally,… more