Utilization review nurse jobs in San Ramon, CA

Job Summary. Manages activities of the unit(s), monitors quality, service and utilization standards.. Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser..

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..

Clinical experience as a Registered Nurse, Social Worker or related field in an acute care, intermediate.. Experience in Utilization Review and compliance with the rules and regulations of the Medicare and..

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job.. Job Description & Requirements Specialty. Utilization Review Discipline. RN Duration. 13 weeks 36 hours..

Conduct concurrent and retrospective review of inpatient and outpatient utilization according to.. Active, unrestricted, California Nursing License. Registered or Licensed Vocational Nurse. Additional..

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..

How you make a difference. The Utilization Management Nurse role involves providing clinical care.. Maintains technical knowledge through attending educational workshops, reviewing publications, utilizing..

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..

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..

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..

Unlock Your Potential with Prestigious Litigation and Document Review Projects as a Newly Licensed.. Familiarity with Document Review Discovery. Leverage your understanding of document review and discovery..

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..

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..