Utilization review nurse jobs in Laguna Niguel, CA

Job Description Job Description AMFM Healthcare is looking for a Utilization Review Case Manager to join.. The UR Case Manager will complete all initial, concurrent, and discharge reviews in a timely manner as..

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..

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..

Day to Day ResponsibilitiesThis position will be in support of the HEDIS Medical Record Review (MRR.. Primary responsibility will be to perform medical record review, & enter findings into abstraction tool..

The PA position has part time inpatient responsibilities in utilization management and care coordination.. Conducts clinical reviews on cases referred by care management staff and or other health care..

Your RoleThe Utilization Management team reviews the inpatient stays for our members and correctly.. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager..

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..

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..

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..

Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member.. High School Diploma GED Required Experience. 2 4 years of experience in a Utilization Review Department..

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..

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

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..

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..

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

weeks 40 hours per week Shift. 10 hours, days Employment Type. Travel Nurse First Job ID. 53638284.. About Nurse First Nurse First Travel Agency is committed to giving travel nurses the best experience..

Ref. 5 1 We are looking for Qualified Nurses who are interested in starting to work as a Registered.. Nurses per shift, normally working night shift,. working 6 days a week, around 9 hours per day, 1 day..