- Providence (Irvine, CA)
- **Description** ** RN Utilization Review at...+ Associate's Degree in Nursing. + Upon hire: California Registered Nurse License + 2 years of ... work Remote 8-hour, Day shifts.** Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and… more
- Fresenius Medical Center (Costa Mesa, CA)
- + This role requires a minimum of 3 years of Dialysis RN experience **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that ... clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Ventura County (Ventura, CA)
- Registered Nurse II - Hematology Oncology (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5011691) Apply Registered ... of the Clinical Manager. PAYROLL TITLE(S) and APPROXIMATE SALARIES: Registered Nurse II: $52.07 - $62.27 hourly...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care… more
- VNA Health (Santa Barbara, CA)
- …7AM - 7:30PM, 3 days per week, rotating weekends Job Description: The Inpatient Registered Nurse provides hospice care and is skilled at assessing pain and ... services, treatments, diagnostic and preventive procedures requiring the skills of a registered nurse according to in-patient facility protocols. + Attend and… more
- Cedars-Sinai (CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K… more
- Sutter Health (San Francisco, CA)
- …+ Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of… more
- CVS Health (CA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... that of other individuals performing similar services. Participate in peer review and performance improvement activities. Practice aseptic techniques as necessary.… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/ rn -case-manager utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… 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 ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices.… more