- Fresenius Medical Center (Sacramento, CA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... Responsible for all required network reporting and on-site state or federal surveys. PATIENT...experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:**… more
- Humana (Sacramento, CA)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File Review Universes and timeliness ... Qualifications** + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health. + Detailed working knowledge… more
- Marriott (Sacramento, CA)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Sutter Health (Sacramento, CA)
- …+ Graduate of an accredited school of nursing. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Sacramento is the foundation of Sutter Health, Northern California's largest health network with 29 acute care hospitals, more than 5,000 primary care physicians… more
- Elevance Health (Sacramento, CA)
- …Qualifications:** + Requires minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any ... card, send you a check, or ask you for payment as part of consideration for employment. ** Nurse Medical Management II** + Job Family: MED > Licensed Nurse +… more
- Elevance Health (Sacramento, CA)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-10 + Previous utilization … more
- Elevance Health (Sacramento, CA)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more