- Molina Healthcare (San Jose, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Managed Care Utilization Management and knowledge ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- … Command Center, participates in daily interdisciplinary team meetings, engages in the utilization management review process, and may participate in rounds on ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Elevance Health (Palo Alto, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... be considered. This position will work a hybrid model ( remote and office). The ideal candidate will must live...programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor… more
- Stanford Health Care (Palo Alto, CA)
- …which serves patients across the world. Its robust network of seven clinical sites staffed by Stanford's team of renowned surgical oncologists, medical oncologists, ... Nurse Professional is Central to the Patient Experience on Clinical Trials: o Ensure a good experience for patients...5:00pm, Hybrid position with 4 days onsite and 1 remote day based on clinic needs. No evenings, weekends,… more