Utilization review nurse jobs in Lincoln, CA

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..

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..

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..

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..

Responsible for maintaining a steady work flow of incoming documents by verifying that accurate information is present per our systems utilizing a checklist. Job Tasks. Review and process..

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..

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..

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

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..

Acentra seeks a Utilization Clinical Reviewer to join our growing team in California. Job Summary As a.. This full time Clinical Reviewer Remote position based in the state of California. This provides an..

weeks 40 hours per week Shift. 8 hours, nights Employment Type. Travel Nurse First Job ID. 52576739.. About Nurse First Nurse First Travel Agency is committed to giving travel nurses the best experience..

Wellspring Nurse Source is seeking a travel Physical Therapist for a travel job in Rocklin, California.. 3 weeks 40 hours per week Shift. 8 hours, days Employment Type. Travel Wellspring Nurse Source Job ID..