Utilization review nurse jobs in Folsom, CA

And Knee. Replacement. Responsibilities The Utilization Review RN is responsible for the review of.. Works in collaboration with the attending physician consultants second level physician reviewer and the..

And Knee. Replacement. Responsibilities The Utilization Review RN is responsible for the review of.. Works in collaboration with the attending physician consultants second level physician reviewer and the..

And Knee. Replacement. Responsibilities. The Utilization Review RN is responsible for the review of.. Works in collaboration with the attending physician consultants second level physician reviewer and the..

Rudish Health is currently seeking qualified candidates for an Interim Case Management Director for a client in Los Angeles, CA. The Interim Case Management Utilization Review Director will..

JOB SUMMARY. The Utilization Review Nurse is responsible for completion of admission, concurrent and.. As appropriate, the UR nurse will assess for clinical stability and coordinate transfer back to Marin..

Job Description Your Role The Utilization Management team reviews the inpatient stays for our members.. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role..

The Utilization Management Nurse, Senior will report to the Manager, Utilization and Medical Review.. Successful RN candidate reviews prior auth requests for medical necessity, coding accuracy and medical..

Join a Prestigious San Francisco Law Firm as a Document Review Attorney for High Profile Litigation.. Bar Admission. Must be licensed to practice law in California. Document Review Experience. Previous..

Qualifications Associates Degree or Bachelor's Degree in nursing or related field. Active Registered Nurse (RN) license required. Must be in good standing. 2. years clinical practice preferred..

WHAT YOU'LL BE RESPONSIBLE FOR Perform concurrent or post service (retrospective) review of acute in.. Utilization Management, and or Case Management principles and practicesMedi Cal and related policies and..

Overview of the Role. Alignment Health is seeking a remote inpatient review nurse (must have California.. Monitor for any over utilization or underutilization activities. Generate referrals as appropriate to..

We are looking for a Data Entry Specialist whose main function is providing excellent customer service by quickly and accurately processing submissions sent electronically by our m..

Urgent Hiring!! Title. Document Review Attorney Work Setup. Remote Job Summary. We are seeking an experienced Document Review Attorney to join our legal team immediately. The firm specializes in..

The Medical Director, Utilization Management functions as a key member of the BSC Promise utilization.. The Medical Director reviews and makes determinations regarding all member and provider requests for..

Utilization Management is responsible to collaborate with healthcare providers and members to promote.. Licensed NursePlease be advised that Elevance Health only accepts resumes for compensation from agencies..

Concurrent Review Nurse II Field Based Rancho Cordova, USA California Sacramento, USA California CA.. Centene Corporation have an immediate need for Concurrent Review Nurse II Field Based. If you happen to..

Job DescriptionA bit about this role. This position interacts with utilization management, clinical.. clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer discussions..

Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively,. Humana ) offers competitive benefits that support whole person well being. Associate benefits ar..

JOB SUMMARY The Transfer DRG Revenue Review Specialist performs work to capture lost revenue for.. The company has reviewed this job description to ensure that the essential functions and basic duties..