- The Cigna Group (Sacramento, CA)
- …Other duties as required and related to this role. **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory of the ... knowledge and acumen to develop models and procedures, and monitor trends, within Nurse Case Management. RN and current unrestricted nursing license required.… more
- Prime Healthcare (Ontario, CA)
- …Administration, or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health ... California Applicants:https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides… more
- CVS Health (Sacramento, CA)
- …and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management/ review experience preferred Outpatient Clinical experience. + Knowledge of… more
- Fresenius Medical Center (Reedley, CA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Select Medical (Los Angeles, CA)
- …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- Sharecare (Sacramento, CA)
- …ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification ... To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Veterans Affairs, Veterans Health Administration (Mcclellan, CA)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Ventura County (Ventura, CA)
- …TRAINING, and EXPERIENCE Requires two (2) years of experience as a full-time professional registered nurse in a clinical nursing patient care delivery ... one (1) year of experience in a quality, informatics, utilization review , compliance or related position. +...two (2) years of experience as a full-time professional registered nurse in a clinical … more
- Ventura County (Ventura, CA)
- Registered Nurse II - ICU/DOU/Telemetry (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4887199) Apply Registered ... or indirect nursing care to patients. Distinguishing Characteristics: The Registered Nurse II class is the experienced...as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Assessment & Referral Registered Nurse PAY RANGE: $63.00-$78.00 per hour REPORTS TO: ... and procedures, ensuring compliance with regulations, standards and requirements. The Registered Nurse - Assessments & Referrals maintains knowledge,… more
- Stanford Health Care (Palo Alto, CA)
- …initiatives. + Translate and implement national initiatives at SHC. **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact ... States of America) **A Brief Overview** The Lead Certified Registered Nurse Anesthetist (CRNA) provides supervision and...provides supervision and management of CRNAs in a distinct clinical service line. The Lead CRNA provides clinical… more
- CVS Health (Sacramento, CA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Sutter Health (Burlingame, CA)
- …: **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire CCM certification ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- Sutter Health (Modesto, CA)
- …weekend **EDUCATION:** + Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire + BLS - ... and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of… more
- CVS Health (Sacramento, CA)
- …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- STG International (Rancho Cucamonga, CA)
- …patient safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... Performance Improvement Team (QPIT) strategic initiatives. + Participate in review and improvement of clinical success in...of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/case-manager%2c- rn utilization - review ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN ...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Stanford Health Care (Palo Alto, CA)
- …years of experience as an RN - 3+ years of experience in case management/ utilization review Why work at Stanford Medicine | Stanford Health Care (SHC)? - ... Knowledge of principles and best practices of case management, utilization review , social work, care coordination and...to address them. **Licenses and Certifications** + Nursing / RN - Registered Nurse -… more