- Cognizant (Sacramento, CA)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (Sacramento, CA)
- …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… 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 ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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 ... education, orientation, competencies and providing quality improvement and outcomes utilization . Demonstrates leadership in delivering and improving holistic, home-based… more
- Centene Corporation (Sacramento, CA)
- …preferred. 25% Travel CA RN License Required **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Sutter Health (Roseville, CA)
- …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 2 ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- Lincoln Financial (Sacramento, CA)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... 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… more
- Molina Healthcare (Stockton, CA)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- Sutter Health (Antioch, CA)
- …+ Graduate of an accredited school of nursing. **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California + BLS-Basic Life Support Healthcare Provider ... Medical Center **Position Overview:** Manages and provides overall operational and clinical nursing leadership to an inpatient department(s) or setting. Plans and… more
- Sutter Health (Sacramento, CA)
- …nursing. **CERTIFICATION & LICENSURE:** + BLS-Basic Life Support Healthcare Provider + RN- Registered Nurse of California **TYPICAL EXPERIENCE:** + 5 years recent ... maintaining high standards of quality and patient safety within this specialized clinical setting. Provides leadership for Clinical Education, overseeing staff… 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 the ... performance reviews* Responsible to ensure that there is a nurse on call after hours for all homes (and...submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least… more
- Molina Healthcare (Sacramento, CA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will… more
- Sutter Health (Roseville, CA)
- …Graduate of an accredited school of nursing. **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California + BLS-Basic Life Support Healthcare Provider ... and assists in meeting financial targets by effectively managing utilization , productivity, personnel and supplies. Participates as necessary in referral… more
- Sutter Health (Sacramento, CA)
- …Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN- Registered Nurse of California + BLS-Basic Life Support Healthcare Provider ... established plan of patient care and ensuring effective management of visit utilization and control of expenses. May assist in agency wide orientation, competency… more
- Sutter Health (Sacramento, CA)
- …**CERTIFICATION & LICENSURE:** + BLS-Basic Life Support Healthcare Provider + RN- Registered Nurse of California + Department: SOPS, ACLS-Advanced Cardiac ... manages capital and operational budgets to achieve financial targets via effective utilization of personnel, resources and supplies. Develops and maintains a solid… more
- Sutter Health (Antioch, CA)
- …school of nursing required + Bachelor's Degree: Preferred **CERTIFICATION & LICENSURE:** + Registered Nurse - State Licensure - RN + Basic Life Support ... Medical Center **Position Overview:** Manages and provides overall operational and clinical nursing leadership to an inpatient department(s) or setting. Plans and… more