- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager /Director, the Supervisor of Utilization Management is responsible ... Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management...accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred… more
- Sutter Health (Sacramento, CA)
- …+ Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Care at Home - Valley **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more
- ERP International (Mcclellan, CA)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN ) Case Manager ** for a full-time position supporting the **McClellan VA Medical ... consideration for the goals and objectives of the MTF's Utilization Management and Medical Management ...of the following certifications: American Nurses Credentialing Center (ANCC), Nurse Case Manager ( RN -NCM), National… more
- Dignity Health (Rancho Cordova, CA)
- …performing team. - Bachelors Degree in Nursing field (BSN). - Clear and current CA Registered Nurse ( RN ) license and Certified Diabetes Care and Education ... to maintaining excellence in care and service. **Responsibilities** **Position Summary:** The Manager , Diabetic Program is involved in direct patient care and is… more
- Intermountain Health (Sacramento, CA)
- … Registered /Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse ( RN ) in Colorado or Compact + Basic ... cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care.… more
- Marriott (Sacramento, CA)
- … Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance & ... N **Position Type** Management **JOB SUMMARY** The Nurse CARE Manager coordinates timely, appropriate, quality,...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Actalent (Sacramento, CA)
- …Skills: + Acute care + Concurrent review + Home health + Health plan + Utilization review + Utilization management + Interqual Additional Skills & ... or claim denial. + The Medi-Cal Appeals and Grievances senior RN will report to the Appeals and Grievances Manager . + In this role, you will perform accurate and… more
- Elevance Health (Sacramento, CA)
- …UM Clinical Guidelines and contract. + Outreaches to providers as necessary for Utilization Management functions. + Collaborating with other BH Care Managers on ... **Sign-on Bonus:** $3,000 The **Behavioral Care Manager ** **II** is responsible for completing clinical assessments,...the United States required. + Previous experience in case management / utilization management with a broad… more
- BrightSpring Health Services (Sacramento, CA)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... of business development & growth, achievement of key performance indicators, management of nursing performance and staff development. Responsibilities * Oversees and… more
- Centene Corporation (Sacramento, CA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... is a remote position.** **Monday-Friday 8am-5pm PST.** **Position Purpose:** Perform care management duties to assess, plan and coordinate all aspects of medical and… more
- J&J Family of Companies (Sacramento, CA)
- …care. The CAR-T Cell Therapy Experience Lead is a member of this account management team, reporting to the Senior Manager , CAR-T Cell Therapy Experience Lead. ... on customer experience in the pharmaceutical industry. Our account management teams support the certified sites who care for...Cell Therapy Manufacturer Home Office or Field Experience + RN license or Advanced Practice degree ( Nurse … more
- CenterWell (Sacramento, CA)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a professional and...Graduate of an accredited school of nursing and current RN state license in good standing OR a graduate… more