- ICW Group (Sacramento, CA)
- …of Workers ' Compensation, Workers ' Compensation Managed Care processes, Utilization Review , Telephonic Nurse Case Management, and Field ... in tracking, resolution gathering, and trending of cost management issues related to bill review , case management and utilization review . + Works closely… more
- Dignity Health (Rancho Cordova, CA)
- …work from home within the Greater Sacramento, CA region.** **Position Summary:** The Utilization Review (UR) LVN uses clinical judgement in providing ... assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may...and documents same in 95% of cases. - Supports co- workers to cover needed staffing, training or special projects… more
- Prime Healthcare (Inglewood, CA)
- …managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Additionally, ... to lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers , and Clinical Coordinators. This leader will oversee all facets of … more
- Prime Healthcare (Chino, CA)
- …for its quality, including as among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- ICW Group (San Diego, CA)
- …regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and ... perform clinical assessment and evaluate needs for treatment in worker 's compensation claims. The Telephonic Nurse Case...Providers. + May perform Utilization Review activities (or review … more
- Ventura County (Ventura, CA)
- …candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of experience ... and review ; + Performs daily clinical reviews to support utilization and quality management, ensuring compliance with guidelines and standards for patients… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. + Maintains knowledge of developmental tasks and ... and substance abuse conditions. POSITION TITLE: Assessment & Referral Registered Nurse PAY RANGE: $63.00-$78.00 per hour REPORTS TO: Director of Assessment… more
- The County of Los Angeles (Los Angeles, CA)
- …an individual's ability to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience, ... NURSE PRACTITIONER- PEDIATRIC HUB CLINICS/NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2588395) Apply NURSE PRACTITIONER-… more
- Sutter Health (Roseville, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more
- Sutter Health (Burlingame, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more