- Novo Nordisk Inc. (San Mateo, CA)
- …Externally, the DCS maintains relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other paramedical ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- The Cigna Group (Sacramento, CA)
- …**Job Description Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate ... for inpatient acute care, rehabilitation, referrals, and select outpatient services. May review initial liability disability claims to determine extent and impact of… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The **Utilization Review RN** is responsible for the ... in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Centene Corporation (Sacramento, CA)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
- Evolent (Sacramento, CA)
- …client policies and procedures while complying with timeliness guidelines. Our clinical nurse reviewer team values collaboration, continuous learning, and a ... the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...set up the appeal, physicians and other clinicians who review the appeal, the claims department to review… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/utilization- review - nurse -lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Plan. Qualifications Required qualifications: + Possess an active CA Licensed Vocational Nurse (LVN) license. + Minimum two years of experience in acute hospital… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Patient Flow Utilization Management/Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical coordination and ... oversight for their patient population. The Nurse is primarily responsible and accountable for assessing, planning, implementing, and evaluating direct and indirect… more
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