- ERP International (Camp Pendleton, CA)
- …education of patients and their families and employee satisfaction. **Additional LPN/ LVN - Duties** . + Provide care coordination for the beneficiaries assigned ... manuals, reports and actively engages patients in their health care. + Review details and expectations regarding referrals with patients. + Provide support to… more
- Dignity Health (Rancho Cordova, CA)
- …position is work from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN , you will use clinical judgement in ... all work activities. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. 5 years LVN experience. -… more
- Dignity Health (Rancho Cordova, CA)
- …is work from home within the Greater Sacramento, CA region.** **Position Summary:** The Utilization Review (UR) LVN uses clinical judgement in providing ... outcomes of patients. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. - 5 years LVN experience. -… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN /LPT $31.50-37.50 Per ... Hour RN/LCSW/LMFT/LPCC $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as...Current license as an LCSW, ASW, AMFT, LMFT, RN, LVN , LPT, or LPCC. + Preferred; Master's degree in… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Veterans Affairs, Veterans Health Administration (Eureka, CA)
- …geriatric patients at the Eureka VA Clinic. Duties and responsibilities of the LVN /LPN include: Performs retrospective medical review of non-VA health care ... of a Allied Health Professional The Intermittent Licensed Vocational Nurse/Practical Nurse ( LVN /LPN) has a broad degree of practical nursing knowledge and skills.… more
- Molina Healthcare (Long Beach, CA)
- …in a medical unit or emergency room. Previous experience in Managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; ACLS… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours**… more
- Actalent (Sacramento, CA)
- …(eg, med-surg, telemetry, ICU) + At least 1 year of experience in utilization review , case management, or hospital discharge planning + Familiarity with ... Remote Licensed Vocational Nurse ( LVN ) Fully remote but MUST reside within 50...of the Sacramento area Job Duties + Perform timely utilization reviews for Medicare inpatient admissions, continued stays, and… more
- Molina Healthcare (Long Beach, CA)
- …care. Essential Job Duties * Performs audits of non-clinical staff in utilization management, care management, member assessment, and/or other teams - monitoring for ... Qualifications * At least 2 years health care experience, preferably in utilization management, care management, and/or managed care, or equivalent combination of… more
- TEKsystems (Canoga Park, CA)
- …RN or LVN with an active license to join our team as a Utilization Review Nurse. In this role, you will conduct retrospective reviews of inpatient and ... highly desirable). + Strong written communication and analytical skills. Position: Utilization Review Nurse Work Environment: Hybrid (onsite & remote)… more
- TEKsystems (Canoga Park, CA)
- Position: Utilization Review Nurse Work Enviroment: Hybrid...We are seeking to hire an experienced RN or LVN with an active license to help address claims ... retro review . This role focuses on reviewing inpatient and outpatient...a managed care environment. Key Responsibilities: + Perform detailed utilization reviews for inpatient and outpatient claims. + Prepare… more
- TEKsystems (Canoga Park, CA)
- JobTitle: Retro Claims Reviewer Location: West Hills/Canoga Park 91304 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is ... This role is ideal for a Licensed Vocational Nurse ( LVN ) or Registered Nurse (RN) with hands-on experience in...) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare… more
- Datavant (Sacramento, CA)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers + Provide proper… more
- Insight Global (Los Angeles, CA)
- …Director. The RN Supervisor will manage on average 5 employees between MA's, LVN 's, RNs and administrative staff. 75% of responsibilities are geared toward staff ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- VNA Health (Santa Barbara, CA)
- …inservice and nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary records and reports in ... and other team members in providing continuity of cared. + Supervise LVN 's, Home Health Aides and Volunteers. + Ensure that arrangements for equipment… more
- Cedars-Sinai (Los Angeles, CA)
- …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint ... Foreign trained MDs will be considered License/Certifications: Registered Nurse, LVN , Occupational Therapist, Physical Therapist, Physician Assistant, foreign MD… more
