- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Fresenius Medical Center (Colton, CA)
- …while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans ... looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL...+ 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
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Assessment & Referral Registered Nurse PAY RANGE: $63.00-$78.00 per hour REPORTS TO: ... and procedures, ensuring compliance with regulations, standards and requirements. The Registered Nurse - Assessments & Referrals maintains knowledge,… more
- VNA Health (Santa Barbara, CA)
- …Shift Differentials + Schedule: 3 days/week, 12 hours/day Job Description: The Inpatient Registered Nurse provides hospice care and is skilled at assessing pain ... services, treatments, diagnostic and preventive procedures requiring the skills of a registered nurse according to in-patient facility protocols. + Attend and… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and...for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator -… more
- Cedars-Sinai (Los Angeles, CA)
- …care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician ... of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required...for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist -… 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/236088/ 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
- 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
- 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
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …Per Hour RN /LCSW/LMFT/LPCC $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary ... opened in 2016 and is regarded as an integral part of the greater Santa Rosa and Northern California...and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50… 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
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... If you're ready to be part of our legacy of hope and innovation,...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- Sharp HealthCare (San Diego, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... nursing expert for assigned areas. **Required Qualifications** + California Registered Nurse ( RN ) - CA...errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of… more
- HCA Healthcare (Thousand Oaks, CA)
- …or spine experience is preferred. + Basic Cardiac Life Support (BLS) - **Required** + ( RN ) Registered Nurse License with the State of California - ... knowledge and expertise! **Job Summary and Qualifications** As a Registered Nurse , you will be responsible for...personal growth, we encourage you to apply for our RN II Ortho Spine opening. We promptly review… more
- CenterWell (Sacramento, CA)
- …CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Use your skills ... **Become a part of our caring community and help us...put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers… more
- Sharp HealthCare (San Diego, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... RN experience in related clinical area. + California Registered Nurse ( RN ) - CA...errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more