• Nurse Appeals ( RN )

    Elevance Health (Palo Alto, CA)
    ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The ** Nurse Appeals ** is responsible for investigating and processing medical… more
    Elevance Health (12/04/24)
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  • Registered Nurse [Experienced…

    City and County of San Francisco (San Francisco, CA)
    …License: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your ... California RN license number in the application, as failure to...least one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent… more
    City and County of San Francisco (10/29/24)
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  • Care Management Clinical Appeals Specialist

    Alameda Health System (San Leandro, CA)
    …at a medical group or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life ... Care Management Clinical Appeals Specialist + San Leandro, CA + Finance...based on identified criteria and ensures the patient is registered at the appropriate level of care; Utilizes McKesson… more
    Alameda Health System (11/19/24)
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  • San Leandro Hospital Case Manager RN , Full…

    Alameda Health System (San Leandro, CA)
    …Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. **Additional Information** ... San Leandro Hospital Case Manager RN , Full Time, Benefited, Days, 8hrs, 1.0fte +...Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
    Alameda Health System (12/06/24)
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  • Clinical Nurse Specialist (Critical Care)…

    City and County of San Francisco (San Francisco, CA)
    …and Certification: + Registered Nurse License: Possession of a valid California Registered Nurse ( RN ) license issued by the California Board of ... Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a valid Clinical ...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
    City and County of San Francisco (12/18/24)
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  • AHD Case Manager RN

    Alameda Health System (Alameda, CA)
    …health preferred. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Required Licenses/Certifications: ... AHD Case Manager RN + Alameda, CA + Alameda Hospital +...contacts with payers conducting phone reviews and initiates denial appeals as needed. 4. Conducts discharge planning assessments in… more
    Alameda Health System (11/08/24)
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  • Licensed Vocational Nurse

    City and County of San Francisco (San Francisco, CA)
    …required. + Administers nursing care to patients according to physician's and Registered Nurse 's instructions and approved nursing and departmental policies and ... an online application Under supervision and according to physicians' or registered nurses' instructions, prepares, administers and records ordered medications and… more
    City and County of San Francisco (12/10/24)
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  • Psychiatric Technician - DPH

    City and County of San Francisco (San Francisco, CA)
    …shifts may be required. ** Under the direction of a licensed physician, registered nurse , or clinical supervisor, the Psychiatric Technician performs responsible ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
    City and County of San Francisco (11/01/24)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... of quality improvement initiatives. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
    Alameda Health System (12/20/24)
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  • Manager, Care Management

    Alameda Health System (Oakland, CA)
    …in a supervisory or lead role. **Required Licenses/Certifications:** Active licensure as a Registered Nurse in the State of California or licensed in Clinical ... and internal compliance studies. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
    Alameda Health System (11/05/24)
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  • Pediatric ED Complex Care Manager (LCSW) - Social…

    Stanford Health Care (Palo Alto, CA)
    …+ LCSW - Licensed Medical Social Worker - State Licensure or + Nursing / RN - Registered Nurse - State Licensure and/or Compact State Licensure ... Health Care Resource Management/ Clinical Cost Efficiency, Financial Assistance/Referrals, Appeals Management, Entitlement Program Coordination, Patient Benefits Coordination: CCS/GHPP/Medicare/Medi-Cal/SSI… more
    Stanford Health Care (11/29/24)
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