• Inpatient Review Case

    Molina Healthcare (San Jose, CA)
    …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and ... expected length of stay for requested treatments and/or procedures. + Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its… more
    Molina Healthcare (12/12/24)
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  • RN Case Manager

    Amergis (Palo Alto, CA)
    RN Case Manager Requirements: + 3+ years of RN Case Manager experience + BLS + EPIC experience + Previous Travel RN exp. + BSN RN preferred Details: ... Start date: 2/3 Duration: 13 weeks, possible extensions Unit: Case Management Inpatient Shift: Days Hours: 4x10s,...hours/week Requirements: CA RN License, 3+ years of RN Case Manager experience , EPIC experience, BLS… more
    Amergis (01/08/25)
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  • Case Manager II

    Sutter Health (Los Altos, CA)
    …**Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The nurse case manager conducts preauthorization, concurrent, and retrospective ... continuity of care using community resources. * For cases not meeting criteria, the case manager documents applicable guideline, rationale, and routes to the UM… more
    Sutter Health (12/31/24)
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  • Clinical Program Manager

    Horizon Services, Inc. (Hayward, CA)
    …months, and $500 after 12 months of employment) JOB TITLE: Clinical Program Manager LOCATION: Hayward, CA Employment Type: Full-time Who are we? Horizon Services, ... in people's lives? We are seeking a Clinical Program Manager who is fluent in one or more of...direct service positions in coordination with the Direct of Inpatient Operation (DIO). + Coordinate and maintain all direct… more
    Horizon Services, Inc. (12/22/24)
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  • Medical Management Clinician Senior

    Elevance Health (Palo Alto, CA)
    …and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or skill of a ... guidelines within scope of licensure. + These reviews may require in-depth review ; however, any deviation from application of benefits plans will require guidance… more
    Elevance Health (01/08/25)
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