Utilization review nurse jobs in Turlock, 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..

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..

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..

JOB RESPONSIBILITIES. Assist to oversee technical design for engineering plans, calculations, and reports, including performing a programmatic review of technical submittals to ensure product..

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..

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..

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..

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 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..

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..