- Dignity Health (Woodland, CA)
- …Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level ... - Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review prior authorizations for medical determination, preferred. - Bachelors… more
- Cognizant (Sacramento, CA)
- …role expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- CVS Health (Sacramento, CA)
- …criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review . + Conduct clinical reviews via phone and electronic ... are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence...At least 1 year of Utilization Management experience in concurrent review or prior authorization. + Strong… more
- Centene Corporation (Sacramento, CA)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... IN STATE OF RESIDENCE.** **Position Purpose:** Performs a clinical review and assesses care related to mental health and...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- Dignity Health (Folsom, CA)
- …including mock survey tracers. **Job Requirements** **Minimum Required** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). + Participates in an integral… more