- Alameda Health System (Oakland, CA)
- Clinical Nurse V + Oakland, CA + Highland General Hospital + FQ MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + ... Minimum Experience: Either (1) Three years full time continuous experience as a Clinical Nurse III with AHS. (2) Two years of full-time continuous experience as… more
- Molina Healthcare (San Francisco, CA)
- …must be current and in good standing. **Preferred Qualifications** * LVN (Licensed vocational nurse ) or RN (Registered Nurse ) . License must be current, active ... managed care UM processes. * Medicaid/Medicare population experience. * Clinical experience. * Supervisory/leadership experience. **Work Schedule: Pacific daytime… more
- Molina Healthcare (San Francisco, CA)
- …and federal regulatory and accrediting standards and implementation of the Molina clinical model. * Manages and evaluates team member performance, provides coaching, ... * At least 1 year of health care management leadership experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. *… more
- Molina Healthcare (San Francisco, CA)
- …**Required Education** Licensed Vocational Nurse / Licensed Practical Nurse . **Required Experience** Minimum three years clinical nursing experience. ... in accordance with cost control standards. **Knowledge/Skills/Abilities** * Performs clinical /medical reviews of retrospective medical claim reviews, medical claims… more
- Molina Healthcare (San Francisco, CA)
- 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 ... hours as posted._** **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that… more
- Molina Healthcare (San Francisco, CA)
- …daytime hours.** **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that ... services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Molina Healthcare (San Francisco, CA)
- …and consultation for NCQA standards/guidelines for the plan including compliant clinical quality improvement activity (QIA) in collaboration with clinical ... chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial… more