- Molina Healthcare (Sacramento, CA)
- …Management / Utilization Review is required for this role. Experience with Case Management is a plus._** **_This is a remote role (work from home). Excellent ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12...illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost… more
- Actalent (Sacramento, CA)
- Job Description: + Attend annual review and department in-services, as scheduled; staff meetings as required. + Support and maintain a culture of safety and quality. ... of results and answers questions per established protocols. + Review in box/PAQ for refills, refill meds per set...an accredited school of nursing. 1 year of any clinical/SNF/ inpatient setting. + Current CA RN license + Communicate… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …with the patient (indicated by patient signatures, initials and dates that each review is completed). + Manages clinical and case management staff workload, ... POSITION TITLE: Clinical Program Manager REPORTS TO (TITLE): Director of Clinical Services...of Clinical Services with oversight in treatment program planning, case management, and evaluation of the effectiveness of clinical… more
- Elevance Health (Sacramento, CA)
- …+ Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service ... referrals given. + Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests… more