- Cognizant (Sacramento, CA)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Actalent (Rancho Cordova, CA)
- Job Title: Utilization Review Nurse Job Description The Registered Nurse will review cases for medical necessity across all levels of care, ensuring that ... and in a team environment. Additional Skills & Qualifications + Two years of strong clinical nursing experience, preferably as a floor nurse or in direct patient… more
- Evolent (Sacramento, CA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Sutter Health (Roseville, CA)
- …**EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN- Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** 2 ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- Sutter Health (Sacramento, CA)
- …Graduate of an accredited school of nursing. **CERTIFICATION & LICENSURE:** RN- Registered Nurse of California BLS-Basic Life Support Healthcare Provider ... at Home - Valley **Position Overview:** Serves as a clinical expert for wound, ostomy, and continence related issues...CWON - Certified Wound Ostomy Nurse **DEPARTMENT REQUIRED CERTIFICATION & LICENSURE** Department, SCAH: DL-Valid… more
- Sutter Health (Sacramento, CA)
- …school of nursing. + **BSN** _Preferred_ **CERTIFICATION & LICENSURE:** + **RN** - Registered Nurse of California + **BLS** -Basic Life Support Healthcare ... SMCS-Sutter Med Center - Sacramento **Position Overview:** The CVOR Nurse Manager provides leadership and operational oversight for the Cardiovascular… more
- Sutter Health (Sacramento, CA)
- …Master's in Healthcare (MPH, MHA, MS, MBA, etc.) **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California OR MD-Medical Doctor OR DO-Doctor of ... + CCS-Certified Coding Specialist within 1 year + CCDS-Certified Clinical Documentation Specialist OR CDIP-Certified Documentation Integrity Practitioner **TYPICAL… more
- Highmark Health (Sacramento, CA)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Sutter Health (Sacramento, CA)
- …education/experience + **Master's: MSN** _Preferred_ **CERTIFICATION & LICENSURE:** + **RN** - Registered Nurse of California + **BLS** -Basic Life Support ... close partnership with SMCS and service line leadership. Optimizing throughput, block utilization , asset management, and patient access with a focus on quality and… more
- Sutter Health (Roseville, CA)
- …Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California + BLS-Basic Life Support Healthcare Provider ... established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency… more