- Centene Corporation (Sacramento, CA)
- …including a fresh perspective on workplace flexibility. Remote Role, California RN Licensing Highly Preferred **Position Purpose:** Performs a clinical retrospective ... review of services previously provided to determine if the...guidelines + Assists with providing education to providers on utilization processes to promote high quality, cost-effective, and efficient… more
- CenterWell (Sacramento, CA)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... utilization reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance with industry… more
- The County of Los Angeles (Los Angeles, CA)
- …an accredited college or university. LICENSE(S) REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a Nurse Practitioner ... Do you have a license to practice as a Registered Nurse issued by the California Board...number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review … more
- The County of Los Angeles (Los Angeles, CA)
- …accredited college or university . LICENSE(S) REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a Nurse Practitioner ... Do you have a license to practice as a Registered Nurse issued by the California Board...number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review … more
- Stanford Health Care (Palo Alto, CA)
- …the processes and outcomes of patient health care **Licenses and Certifications** + Nursing / RN - Registered Nurse - State Licensure and/or Compact State ... | Stanford Health Care (SHC)? Are you a seasoned RN Case Manager? Here is your opportunity to work...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- The County of Los Angeles (Los Angeles, CA)
- …calendar days from application submission. LICENSE(S) REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a Nurse ... Do you have a license to practice as a Registered Nurse issued by the California Board...to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your… more
- Molina Healthcare (San Diego, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of InterQual… more
- HCA Healthcare (Riverside, CA)
- …a balance of optimal care and appropriate resource utilization . Requirements: + Registered Nurse ( RN ) with current California license required, Case ... the opportunity to make a real impact. As an RN Case Manager you can be a part of...Management Certification or utilization review preferred + Associate's Degree minimum… more
- Sharp HealthCare (San Diego, CA)
- …End Time** ACLS Certification (Advanced Cardiac Life Support) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... nursing expert for assigned areas. **Required Qualifications** + California Registered Nurse ( RN ) - CA...errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of… more