- Centene Corporation (Sacramento, CA)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The **Utilization Review RN** is responsible for the ... Utilization Review product(s) used + Proficient in application of clinical guidelines (MCG/InterQual) preferred + Knowledge of managed care and payer environment… more
- Alameda Health System (Oakland, CA)
- …utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal ... Nurse , Care Management + Oakland, CA + Highland...develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of care,… 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
- 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 ... 7/3/2025, 10/3/2025 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… 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
- Dignity Health (Oxnard, CA)
- …daily rounding and monitoring on our patients during hospitalization. The NP will review all medical record documentation on a concurrent basis to ensure ... In keeping with Dignity Health Core Values, the Electrophysiology (EP) Nurse Practitioner works with the Electrophysiologists to ensure our patients receive… more
- Prime Healthcare (Inglewood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse (RN) license is required. 2. Five years acute care nursing… more
- Prime Healthcare (Inglewood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... illness. Qualifications EDUCATION, EXPERIENCE, TRAINING + A current California State Registered Nurse (RN) license is required. + Five years acute care nursing… more
- Prime Healthcare (Inglewood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse (RN) license is required. 2. Five years acute care nursing… more
- The Cigna Group (Sacramento, CA)
- …**Job Description Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate ... acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor ... patients.Interfaces with Business Office regarding ongoing certification of stay.Provides concurrent and retro UR reviews to Review Organizations.Identifies… more
- UCLA Health (Los Angeles, CA)
- …with the Cardiology Clinic Operations Manager, you will be accountable for the clinical care and the daily operations of the clinic. Duties include but are ... + Provide leadership and direct supervision, monitoring, and evaluation of the clinical and administrative clinic staff. + Coordination of clinical services… more
- UCLA Health (Los Angeles, CA)
- …population. This will involve collaborating and consulting with a multi-disciplinary clinical /professional team as well as patients and families to ensure safe ... utilization reviews, including authorization reviews + Ensure delivery of concurrent and post-hospital care + Initiate referrals, coordinate resource utilization,… more
- Molina Healthcare (Sacramento, CA)
- **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 NIGHT SHIFT: 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will rotate._** **_TRAINING SCHEDULE ... all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence...experience in Hospital Acute Care, ER or ICU, Inpatient/ Concurrent Review , Utilization Review /… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening + Nursing + Req ... 22, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare… more
- Providence (Mission Hills, CA)
- …retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all ... **Description** RN - Utilization Review for our centralized Utilization Management team for...by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in… more
- Sacramento County (Sacramento, CA)
- …Psychologist, Licensed Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may be cause for ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may… more
- Stanford Health Care (Palo Alto, CA)
- …improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; ... third-party payers to assure reimbursement for patient services/procedures. Communicates with review organizations / payers to provide requested clinical and… more
- Stanford Health Care (Palo Alto, CA)
- …improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; ... payers to assure reimbursement for patient services/procedures. Communicates with review organizations/payers to provide requested clinical and psychosocial… more