- Alameda Health System (San Leandro, CA)
- …preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or ... resource Management issues; other issues including concerns involving under/over utilization , avoidable days and quality issues. Coordinate daily with… more
- HCA Healthcare (Riverside, CA)
- …Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + Associate's Degree minimum required + ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Alameda Health System (San Leandro, CA)
- …preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or ... resource Management issues; other issues including concerns involving under/over utilization , avoidable days and quality issues. Coordinate daily with… more
- Providence (Napa, CA)
- **Description** Social Worker MSW in Utilization Review Unit at Queen of the Valley Medical Center, CA. This position is Full time and will work 8-hour Day ... Full time **Job Shift:** Day **Career Track:** Clinical Professional **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas St **Work… more
- Teleflex (Los Angeles, CA)
- …and world-class products can shape the future direction of healthcare. Teleflex is the home of Arrow (TM) , Barrigel (TM) , Deknatel (TM) , QuikClot (TM) , ... meetings is an ongoing responsibility and administrative duties include expense report review to assure compliance with company policies and regular utilization … more
- Evolent (Sacramento, CA)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review determinations and… more
- Evolent (Sacramento, CA)
- …care, HIPAA, provider and vendor contracting, compliance, population health (including utilization management), Medicare, and Medicaid. + Draft, review and ... President, Deputy General Counsel, the Attorney will prepare and review a variety of complex contracts and provide legal...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. EDRP ... Duties and responsibilities of the LVN/LPN include: Incumbent performs retrospective medical review of non-VA health care records to determine medical necessity of… more
- Veterans Affairs, Veterans Health Administration (Eureka, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to determine medical necessity… more
- CVS Health (Sacramento, CA)
- …with transferring patients to lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation preferred - 1+ ... with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** **Shift schedule is 8:30am -… more