- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals Lead (RN)** **Location** : This role requires associates to be in-office **1-2 days per week** , fostering collaboration and connectivity, while ... locations may be considered. **Shift:** Monday to Friday from 8:00am-5:00pm **PST** The ** Nurse Appeals Lead** is responsible for serving as a team lead and for… more
- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Actalent (Rancho Cordova, CA)
- Job Title: Registered NurseJob Description The Commercial Appeals and Grievance Registered Nurse (RN) reviews and processes appeals resulting from ... reviewing all medical records and documentation concurrently while processing these appeals . The role involves performing accurate and timely first-level reviews… more
- Centene Corporation (Sacramento, CA)
- …Hours. **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical ... + Communicates with members, providers, facilities, and other departments regarding appeals requests + Generates appropriate appeals resolution communication and… more
- Actalent (Rancho Cordova, CA)
- Hiring a Registered Nurse for a great healthcare company in CA - Fully Remote! Must have CA License, managed care experience, and at least Acute or Sub-Acute ... clinical experience! Appeals & Grievances Location: Remote (No travel required) Schedule:...rationale for decisions. Required Qualifications: + Licensure: Active Registered Nurse (RN) license in the state of California. +… more
- Sacramento County (Sacramento, CA)
- Supervising Public Health Nurse Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/600083) Apply Supervising Public Health Nurse Salary ... One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two years of...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse D/CF Salary ... 5:00 pm on: 2/3/25, 4/7/25, 6/2/25, 8/4/25, 10/6/25, 12/1/25 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory class in… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 4/4/2025, 7/3/2025, 10/3/2025 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties,… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 11/5/2024, 1/2/2025, 3/6/2025, 5/8/2025, 7/3/2025, 9/4/2025, 11/6/2025 Registered Nurse D/CF Level I: $61.27 - $74.48 hourly Registered Nurse D/CF… more
- Sacramento County (Sacramento, CA)
- Nurse Practitioner Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1780920) Apply Nurse Practitioner Salary $127,576.80 - $155,096.64 ... pm on: 3/28/2025, 4/25/2025, 5/23/2025, 6/20/2025, 7/25/2025, 8/22/2025, 9/26/2025, 10/24/2025 Nurse Practitioners provide a range of health care services involving… more
- City and County of San Francisco (San Francisco, CA)
- …and over 15 primary care health centers. Under general supervision, the Nurse Manager-Long Term Care/Geriatric Nursing supervises the delivery of patient care at ... acute care/skilled nursing facility with rehabilitation services. The 2322 Nurse Manager-Long Term Care/Geriatric Nursing performs the following essential job… more
- City and County of San Francisco (San Francisco, CA)
- …The list resulting from this recruitment may be used to fill 2328 Nurse Practitioner - Occupational Health Specialty positions for the next six months. As ... Under general nursing and medical direction, utilizing standardized procedures, the Nurse Practitioner functions within an organized system for the delivery of… more
- City and County of San Francisco (San Francisco, CA)
- …an accredited college or university; AND + License and Certification: + Registered Nurse License: Possession of a valid California Registered Nurse (RN) license ... the California Board of Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a valid Clinical ...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Select Medical (Los Angeles, CA)
- …and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse (RN) or Social Worker (LCSW) **Per Diem** **Pay Rate: $66.00** 2,500 Sign on ... overseeing negotiations of continued stay rationale, length of stays, and appeals process. Initiates activities to develop positive business relationships with… more
- City and County of San Francisco (San Francisco, CA)
- …+ Administers nursing care to patients according to physician's and Registered Nurse 's instructions and approved nursing and departmental policies and procedures; as ... by nursing service policy. + The 2312 Licensed Vocational Nurse may perform other duties as assigned/required + LICENSE:...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- City and County of San Francisco (San Francisco, CA)
- …Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your California RN license ... one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent to 2,000 hours...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Sutter Health (Sacramento, CA)
- …**Organization:** SMF-Sutter Med Foundation- Central **Position Overview:** The Grievances & Appeals Specialist RN supports the patient and family experience by ... of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN-Registered Nurse of California **TYPICAL EXPERIENCE:** 2 years recent relevant experience… more
- Elevance Health (Costa Mesa, CA)
- …will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive care. + Perform ... physician-level case review, following initial nurse review, of chemotherapy regimens. + Determine medical necessity...a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations.… more
- The County of Los Angeles (Los Angeles, CA)
- …be accepted. DEFINITION: Plans, organizes, assigns, directs, and evaluates, through subordinate nurse evaluator supervisors, the work of a major section of the ... direction, through Supervising Health Facilities Evaluator, Nursing positions, to nurse evaluators responsible for surveying and investigating health care facilities… more