- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse 2...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Dignity Health (Woodland, CA)
- …- Three (3) years acute care or related experience including experience in case management utilization review or discharge planning. - Clear and current CA RN ... for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level of care and medical necessity using InterQual… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. + Maintains knowledge of the developmental tasks ... customer service standards. Requirements Knowledge and Experience: + Current California RN license + Inpatient psychiatric experience preferred + Familiarity with… more
- Dignity Health (Sacramento, CA)
- …of patient satisfaction. The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required by ... clinic for victims the Human Trafficking Medical Home. **Responsibilities** The RN Care Coordinator is responsible for assessing planning facilitating and advocating… more
- Sharecare (Sacramento, CA)
- …support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... Hours are on Central Standard Time. **Job Summary:** The RN has the responsibility for supporting the goals and...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- ICW Group (Sacramento, CA)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and… more
- Insight Global (Sacramento, CA)
- …care is being delivered Participates in the Outcomes Management and annual program review Performs utilization review of continuous care and inpatient ... Verifies/approves admitting IPOC diagnosis, treatments, staffing and supplies Monitors utilization of resources by every patient to assure cost effective… more
- Highmark Health (Sacramento, CA)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. . Maintains knowledge of the developmental tasks ... with the CA Board of Behavioral Sciences (AMFT, ACSW, or APCC), or Registered Nurse . Current Cardiopulmonary Resuscitation (CPR) certification, or obtained… more
- Highmark Health (Sacramento, CA)
- …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care… more
- Insight Global (Sacramento, CA)
- …Haves: MINMUM QUALIFICATIONS Education Qualifications AA or Bachelor of Science in Nursing Registered Nurse License in California BLS - Basic Life Support CPR ... reimbursement! 67 cents per gallon. 10-60 miles radius. A Brief Overview Hospice Nurse Case Manager Day-To-Day: you will visit 4-6 patients a day depending on… more
- Guardian Life (Sacramento, CA)
- **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
- Evolent (Sacramento, CA)
- …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... , you will be a key member of the utilization management team. We can offer you a meaningful...a Registered Nurse ) + Strong interpersonal and communication… more
- Elevance Health (Sacramento, CA)
- **Wellness Nurse Consultant** **Sign Bonus: $5000** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of ... is the territory/market that they will work in._ The **Wellness Nurse Consultant** position is responsible for developing and recommending customized, group-specific… more