- Elevance Health (Walnut Creek, CA)
- ** Utilization Management Representative I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative I** is responsible for coordinating cases...I** is responsible for coordinating cases for precertification and prior authorization review. **How will you make an impact:**… more
- Amazon (Palo Alto, CA)
- …the Role This position will be part of the Sponsored Product Demand Utilization team within the Amazon Advertising organization. You will work hands-on with ... systems. This position is ideal for an engineer with prior MLOps or MLInfra experience looking to have exposure...while delivering impact across teams in the SP Demand Utilization Org. You will have experience working with multiple… more
- CenterWell (Sacramento, CA)
- …Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- CenterWell (Sacramento, CA)
- …Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- Prime Healthcare (Chino, CA)
- …an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219949/case-manager-%28rn%29 utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityChino Valley Medical… more
- Prime Healthcare (San Dimas, CA)
- …an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited ... 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 Dimas Community… more
- Molina Healthcare (Los Angeles, CA)
- …Nursing **Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge ... financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes requests… more
- Providence (Orange, CA)
- …in Bio-Medical Engineering or related field. + 2 years Medical device experience. + Prior utilization of Paceart database. + 1 year Cardiac catheterization lab ... highly desirable + Experience with documentation and technical writing skills in a regulated compliance environment. + Electronic medical records highly desirable. **Why Join Providence?** Our best-in-class benefits are uniquely designed to support you and… more
- Dignity Health (Rancho Cordova, CA)
- …guidance and supervision of the department Manager/Director the Supervisor of Utilization Management is responsible and accountable for coordination of services for ... the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is responsible… more
- Stanford Health Care (Palo Alto, CA)
- …+ Skills/Abilities: + Experience resolving issues in financial reimbursement billing, utilization management and government programs + Prior experience ... role screens uninsured and underinsured patients at bedside and prior to or post services to identify government or..."risk" of cases that have not been financially cleared/secured prior to service. Clears low risk cases, escalates high-risk… more