- Evolent (Sacramento, CA)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Cognizant (Sacramento, CA)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more
- The Cigna Group (Sacramento, CA)
- …outcomes, client growth and retention, and network performance. **OVERVIEW:** + The Nurse Executive Sales Specialist, trusted Clinical Leader, Educator and ... including medical cost driver analysis and action, complex case review , referral and engagement, account renewal consultation and recommendations to positively… more
- County of El Dorado (Placerville, CA)
- … Clinical Affairs Section, located in Placerville, CA The Public Health Nurse (PHN) in the Clinical Affairs section, Communicable Disease and Immunizations ... Clinical Affairs Section, located in Placerville, CA The Public Health Nurse (PHN) in the Clinical Affairs section, California Children's Services (CSS)… more
- Sacramento County (Sacramento, CA)
- Nurse Practitioner Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1780920) Apply Nurse Practitioner Salary $132,483.60 - $161,026.56 ... 9/26/2025, 10/24/2025, 11/26/25, 12/26/25, 1/23/26, 2/27/26, 3/27/26, 4/24/26, 5/22/26, 6/26/26 Nurse Practitioners provide a range of health care services involving… more
- Sacramento County (Sacramento, CA)
- …Interviewing techniques + Common current medical terminology + Use and care of medical equipment used in clinical and infirmary settings + Basic medical ... Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary… more
- Sacramento County (Sacramento, CA)
- …Interviewing techniques + Common current medical terminology + Use and care of medical equipment used in clinical and infirmary settings + Basic medical ... 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)… more
- CVS Health (Sacramento, CA)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- CVS Health (Sacramento, CA)
- …criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review . + Conduct clinical reviews via phone and electronic ... Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care… more
- Cardinal Health (Sacramento, CA)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Fujifilm (Sacramento, CA)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …with the patient (indicated by patient signatures, initials and dates that each review is completed). Oversees maintenance of patient clinical records and ... POSITION TITLE: Director of Clinical Services REPORTS TO: Chief Executive Officer (CEO)...patient care. Collaborates with Chief Executive Officer (CEO), Chief Nurse Office (CNO), and Director of Performance Improvement and… more
- Wellpath (Placerville, CA)
- …education, and point of care support. **How you make a difference** The Clinical Operations Specialist is a Registered Professional Nurse with advanced expertise ... **Perks and Benefits** In addition to comprehensive benefits including medical , dental, vision, paid time off, and 401k, we...a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We… 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 ... hours as posted._** **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying… more
- Molina Healthcare (Sacramento, CA)
- … medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial ... practice patterns and recommends corrective actions as needed. * Fosters clinical practice guideline implementation and evidence-based medical practices. *… more
- Dignity Health (Woodland, CA)
- …patient care services that support the physician / provider's practice under the clinical supervision of the Physician, Registered Nurse , Nurse Practitioner, ... and care provided to the patient in the patient's medical record for the physician's review +...the patient's medical record for the physician's review + Administrating medications specifically directed by the physician… more
- Fresenius Medical Center (Sacramento, CA)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- County of El Dorado (Placerville, CA)
- …a Licensed Clinical Social Worker, Marriage and Family Therapist, Registered Nurse , Licensed Clinical Psychologist, or Psychiatrist in the State of ... Marriage and Family Therapist, Licensed Professional Clinical Counselor, Licensed Clinical Psychologist, Psychiatrist or Registered Nurse in the State of… 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 ... Psychologist, Licensed Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may be cause for… more
- County of El Dorado (Placerville, CA)
- …Marriage Family Therapist (LMFT), a Licensed Professional Clinical Counselor (LPCC), a Clinical Psychologist, or a Registered Nurse ? Required for IB/II + Yes ... Plan, organize and provide day-to-day direction, training and work review to volunteers providing similar or related mental health...above and a license to practice as a Licensed Clinical Social Worker, Marriage and Family Therapist, or … more