- CVS Health (Sacramento, CA)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in pacific time zones… more
- CVS Health (Sacramento, CA)
- …constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of ... years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. +… more
- Lincoln Financial (Sacramento, CA)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- CVS Health (Sacramento, CA)
- …unrestricted state licensure required in state of residence **Preferred Qualifications** Utilization Management review Managed Care experience Client processing ... experience **Education** Registered Nurse **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 -… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for...external committees as delegated or assigned. Serves as a consultant to other departments or organizations as needed. Responsible… more
- Highmark Health (Sacramento, CA)
- … **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- ERP International (Port Hueneme, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... algorithms, CM software, databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case management with… more
- Alameda Health System (Oakland, CA)
- …the continuum. + Manages and assumes responsibility for day-to-day operations of utilization management , care coordination and discharge planning activities. + ... committees and in conjunction with the Director of Care Management identifies utilization issues affecting the quality...+ Review cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical… more
- Dignity Health (Bakersfield, CA)
- …act as an expert clinical and education resource; staff and leadership development consultant ; and Utilization Management content expert for staff, leaders, ... physicians and customers across the ePH Utilization Management . This position will assist with...Nursing, Social Work or equivalent experience - Active Registered Nurse (RN) or Social Worker (SW) license in good… more
- Sharp HealthCare (San Diego, CA)
- …**Shift Start Time** **Shift End Time** Master's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - ... risk for adverse health outcomes, and utilize condition-specific targeted interventions, disease management , case management or complex case management … more