- Sutter Health (Sacramento, CA)
- …internally and externally, including clinical and support staff, other departments, management , Sutter Health clinical nurse educators, college staff, regional ... identified learning needs, department goals, quality improvement measures, risk management , regulatory changes, and compliancy criteria. Designs educational offerings… more
- Sutter Health (Sacramento, CA)
- …SHSO-Sutter Health System Office-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that the ... movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as… more
- Sutter Health (Davis, CA)
- …case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... management , quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers… more
- CVS Health (Sacramento, CA)
- …information is necessary and will involve computer system data entry, data management , and reporting. - Review criteria-based prior authorizations following ... and will not be patient facing. The Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)...assignments as delegated by the PA leadership team. - Utilization of clinical skills to support the documentation and… more
- Evolent (Sacramento, CA)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more