- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR ... monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates… more
- Elevance Health (Costa Mesa, CA)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... The Med Mgmt Clinician Sr is responsible for ensuring appropriate, consistent...more junior Clinicians. Approval decisions may be subject to review by more senior nurses or Medical Director. Primary… more
- Sharp HealthCare (San Diego, CA)
- …department + Must remain in original job title + Transfers to a non -bonus eligible department or position may result in forfeiting your remaining incentive bonus. ... correct billing codes and modifiers as appropriate.Demonstrate competency in utilization of computer applications including RIS, PACS, voice recognition,… more
- Sutter Health (Concord, CA)
- …of practice Fiscal Responsibility (includes productivity, HHRG rating, supply management, utilization review ) * Demonstrates ability to prioritize individual ... toward goals to the Clinical Manager or Primary Care Clinician on a regular basis * Reports variances from...sources and community agencies * Demonstrates knowledge and appropriate utilization of internal, community resources to meet patient needs… more
- Elevance Health (Los Angeles, CA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... The Med Mgmt Nurse CA is responsible for review of the most complex or challenging cases...process improvement initiatives. + May help to train lower-level clinician staff. Requirements: + a minimum of associate's degree… more
- Hologic (San Diego, CA)
- …conflicts, and business justifications and trade-offs related to resource utilization . **Technical Investigation:** + Oversee the investigation of product quality ... issues from the field, deviations, and non -conformances. + Coordinate with cross-functional teams to identify root...(HHE) and ultimately lead a risk discussion with a clinician and product subject matter expert. + Responsible for… more