- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance...Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Providence (Mission Hills, CA)
- …must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working ... Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse… 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 ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Ventura County (Ventura, CA)
- …Health Care Agency - Ventura County Medical Center/ Santa Paula Hospital APPROXIMATE SALARIES: Registered Nurse II ( RN II): $51.30 - $61.35 per hour ... Registered Nurse II - Emergency Department...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care… more
- Ventura County (Ventura, CA)
- Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per Diem Print ... (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4935075) Apply Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per… more
- Ventura County (Ventura, CA)
- Registered Nurse II - ICU/DOU/Telemetry (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4887199) Apply Registered ... or indirect nursing care to patients. Distinguishing Characteristics: The Registered Nurse II class is the experienced...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care… 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
- Ventura County (Ventura, CA)
- Registered Nurse II - Pre-op/PACU Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5088990) Apply Registered Nurse II - Pre-op/PACU ... safely regain consciousness and stabilize after surgery. PAYROLL TITLE: Registered Nurse II WHAT WE OFFER: The...and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse III - Emergency Services - Santa Paula Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5094987) Apply Per Diem ... Registered Nurse III - Emergency Services -...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care… more
- Sutter Health (Sacramento, 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
- Sutter Health (Burlingame, CA)
- …: **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire CCM certification ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- CVS Health (Sacramento, 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 ... management/prevention. Lead position requires at least 4 years experience Licensure:** Current, full , active, and unrestricted RN license from any state. Life… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/ rn -case-manager utilization - ... compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
- Centene Corporation (Sacramento, CA)
- …management principles preferred. 25% Travel CA RN License Required **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review … more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... utilization reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance with industry… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- CenterWell (Sacramento, CA)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
