- 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)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. 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)
- …+ 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
- 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
- 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
- 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
- CVS Health (Sacramento, CA)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Evolent (Sacramento, CA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Sharecare (Sacramento, CA)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… 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
- 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