- Dignity Health (Rancho Cordova, CA)
- …position is work from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN, you will use clinical judgement in providing ... utilization management (UM) services. The focus is...assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may… more
- Integra Partners (Troy, MI)
- …funded programs; no current or past OIG or state sanctions + Experience performing utilization management or clinical review activities + Strong written and ... The Utilization Review Medical Director is responsible...Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried… more
- US Tech Solutions (Chicago, IL)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE...with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an… more
- US Tech Solutions (May, OK)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- TEKsystems (Los Angeles, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims ... Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation: LVN...RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with… more
- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Prime Healthcare (Sherman Oaks, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case-manager- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Team of Dedicated Healthcare Workers Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/ utilization - review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... (2) two years of experience in acute hospital case management or equivalent. + Utilization Management...acute hospital case management or equivalent. + Utilization Management experience required. + Excellent interpersonal… more
- Liberty Healthcare Corporation (Salisbury, MD)
- …people who are living with developmental disabilities + Service coordination + Case management + Utilization review + Prior authorizations + Claims ... their best lives. To support this initiative, Liberty is now hiring for a full-time Utilization Reviewer position. As a Utilization Reviewer , your daily… more