Utilization review nurse jobs in Mission Viejo, CA

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..

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..

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..

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..

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..

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..

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..

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 Title. Clinical Trial Education and Literature Review SpecialistFully remote role. EST is.. This role is also responsible for conducting comprehensive literature reviews to assess the landscape of..

weeks 40 hours per week Shift. 10 hours, days Employment Type. Travel Nurse First Job ID. 52485989.. About Nurse First Nurse First Travel Agency is committed to giving travel nurses the best experience..

We're looking for Cardiovascular Operating Room RNs for an immediate travel nurse opening in Mission.. Our CVOR Travel Nurses demonstrate advanced clinical expertise in circulating and scrubbing for a..

Nurse Next Door. Do you want to make lives better? Do you love working with seniors? Nurse Next Door has.. We are hiring for Caregivers at Nurse Next Door to serve our clients located in Napa Valley and Santa..

We are looking for a highly skilled Remote Nurse or Monitoring Specialist who will monitor patients' vitals and determine whether they are in or out of range. Formal education as a Registered..

Details of the NP. General Medicine opening in , CA Anticipated Start Date. 11 11 2024Anticipated Pay Range. 0.00. 0.00Anticipated Duration of Assignment. 13 WeeksAnticipated Sched..

on July 1, 2025 Bargaining Unit. CNA. Registered Nurses Unit. The Health Services Department of.. Charge Nurses are responsible for maintaining and advancing quality patient care standards on an..