- Molina Healthcare (San Diego, CA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (San Diego, CA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 NIGHT SHIFT 7:30PM...in the USA if they have a valid CALIFORNIA RN license and must work the Pacific Time Zone… more
- Molina Healthcare (CA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Centene Corporation (Sacramento, CA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... are seeking a Licensed Clinical Behavioral Health Professional or RN to join our team! The ideal candidate will...preferred. Experience working with providers and healthcare teams to review care services related to mental health… more
- Centene Corporation (San Diego, CA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... abuse is preferred. + Experience working with providers and healthcare teams to review care services, precertification, concurrent review , discharge reviews… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per Hour RN /LCSW/LMFT/LPCC $54.00-64.00 ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- …Psychology or related field; or Bachelor's degree when also possessing a Psychiatric Registered Nurse certification, and Two to three years of progressively ... Therapist (or) Licensed Clinical Social Worker (or) Licensed Psychologist (or) Psychiatric Registered Nurse Knowledge, Skills, and Abilities Knowledge of: +… more
- Highmark Health (Sacramento, CA)
- …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
- Datavant (Sacramento, CA)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Valor Health (Escondido, CA)
- … Clinic Administrator Escondido, CA (http://maps.google.com/maps?q=815+East+Pennsylvania+Avenue+Escondido+CA+USA+92025) * Registered Nurse Apply Job Type ... clinician , and business leaders dedicated to providing exceptional care and a world-class patient experience for our nation's...degree preferred. + Current license or certification as a registered nurse from the state in which… more