Utilization review nurse jobs in Highland, CA

Advancement opportunities within the organization Job Description The Utilization Review Case Manager.. The Utilization Review Case Manager will submit accurate utilization reviews on an extremely tight..

post graduation of an accredited school of nursing and a current state Registered Nurse license.2.. careers primehealthcare.icims.com jobs 173003. case manager 2c rn. utilization review job?mode..

Starting April 1 2015. Minimum 5 years work experience post graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015..

Your Role Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial.. Manages and monitors prior authorization and concurrent review to ensure that the patient is getting the..

We are seeking a detail oriented QA QC Technical Reviewer for electrical systems to perform technical.. Duties. Performs technical review of proposed electrical plans and specifications submitted by District..

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..

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..

Description Title. RN, Coordinator Quality Peer Review Location. Long Beach Department. Q uality.. Education Licensure Certification. Current Registered Nurse (RN) license in state of California required..

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..

Coordinate the Medical, Legal, and Regulatory (MLR) Review process for all medical and commercial.. Maintain comprehensive records of MLR review activities, approvals, and changes to ensure proper..

You can do all this and more at UCLA Health. Under the direction of the Utilization Management.. Work directly with a nurse team lead. Review pending claims for approval or denial Salary Range. 34.37..

RN Case Manager with experience as follows. Must have strong Utilization Review and InterQual experience REQUIRED! Conducting patient initial assessments Acute Care hospital experience EPIC EMR..

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..

EMERGENCY ROOM ADMISSIONS REVIEW NURSE. PERMANENT SHIFT WILL BE. 12 hour NIGHT SHIFT. 7 30PM (in the.. Previous experience with Emergency Room Utilization Management. Utilization Review is required for this..

Consilio LOD is seeking Legal Reviewers across legal practice areas for a remote, full time contract opening with our client, a state based healthcare program vital to over a million Tennesseans..

Forbes Best in State EmployerBill Review Trainer. Hearing SpecialistPRIMARY PURPOSE. To develop and.. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reviews upcoming hearings and prepares necessary documentation..

The Director, eData Managed Review provides administrative oversight to assigned eData managed review.. ensuring managed review legal staff meet all administrative requirements for managed reviews, and..

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..

The UR Case Manager follows the UR process as defined in the Utilization Review Plan in accordance with.. Bachelors Degree in Nurse preferred.California RN License required.Experience. Minimum of 2 years..