- Centene Corporation (Sacramento, CA)
- …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, ... Hours with occasional weekends and holidays.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- Molina Healthcare (Sacramento, CA)
- …or master's degree in a healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** ... Nurse (LPN) license in good standing OR a clinical license in good standing, such as LCSW, LPCC...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Sacramento County (Sacramento, CA)
- Nurse Practitioner Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1780920) Apply Nurse Practitioner Salary $127,576.80 - $155,096.64 ... pm on: 3/28/2025, 4/25/2025, 5/23/2025, 6/20/2025, 7/25/2025, 8/22/2025, 9/26/2025, 10/24/2025 Nurse Practitioners provide a range of health care services involving… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 5/8/2025, 7/3/2025, 9/4/2025, 11/6/2025 Registered Nurse D/CF Level I: $61.27 - $74.48 hourly Registered...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 7/3/2025, 10/3/2025 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- CVS Health (Sacramento, CA)
- …frontline advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management ... leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are… more
- CVS Health (Sacramento, CA)
- …enhance a member's overall wellness through integration. + Through the use of clinical tools and information/data review , conducts an evaluation of member's ... as well as smooth transition to Aetna programs and plans. + Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and… more
- The Cigna Group (Sacramento, CA)
- …**Job Description Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate ... acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate… more
- Dignity Health (Rancho Cordova, CA)
- …Woodland Clinic Medical Group through an interdisciplinary process that provides a clinical and financial approach through the continuum of care. Promotes the ... cost effectiveness of medical care by ensuring department staff are applying clinical acumen and the appropriate application of policies and guidelines to Managed… more
- Centene Corporation (Sacramento, CA)
- …appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH ... (BCBA) required. Master's degree for behavioral health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or assess ABA… more
- Molina Healthcare (Sacramento, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 NIGHT SHIFT: 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will ... all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Sacramento County (Sacramento, CA)
- …Psychologist, Licensed Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may be cause for ... they have not submitted their applications and all documentation prior to 5:00 pm on the cut-off date. +...Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may… more
- Veterans Affairs, Veterans Health Administration (Mather, CA)
- … nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting ... will be to provide day to day administrative support for the Anatomic Pathology and Clinical Laboratory as needed and may be asked to do other duties related to… more
- Veterans Affairs, Veterans Health Administration (Mather, CA)
- … nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting ... Support Assistant and provides clerical and administrative support for multiple Clinical Departments. Monitors the status and progress of work, makes day-to-day… more
- Public Consulting Group (Sacramento, CA)
- …learn more, visit www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager. The Case Manager will be ... providing case management services, assisting families and program recipients through prior approval of certain healthcare services, and collaborating with the… more
- Sedgwick (Sacramento, CA)
- …Workplaces in Financial Services & Insurance RN Consultant Sr - Professional Liability ** Prior Legal Nurse Consulting expereince highly preferred in order to be ... Consultant) Certification or training preferred. **Experience** Five (5) years related clinical nursing experience and two (2) years nurse consultant experience… more