Utilization Review jobs in Sacramento, CA

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Jobs 21 to 30 of 217
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Client Manager

Benefit and Risk Management Services - Folsom, CA
Review accounts on a monthly basis. Respond to Anthem Blue Cross Utilization Management update requests. Review daily and monthly reports, transactions, and...
1 day ago - save job - email - more...

MEDICAL REVIEW RN

Dignity Health - Mercy Sacramento - Rancho Cordova, CA
Completes medical necessity utilization reviews and documents those reviews in MIDAS+ within required timeframes....
Miracle Workers - 2 days ago - save job - email - more...

Research Manager II

Calpers 9 reviews - Sacramento, CA
$32.82 - $40.78 an hour
In addition, HPRD conducts healthcare cost and utilization research, provides analytic support for Cal. Review staff work products for accuracy, appropriateness...
16 days ago - save job - email - more...

Senior Clinical Appeals RN, Sacramento, CA OR Phoenix, AZ

UnitedHealth Group 1,577 reviews - Sacramento, CA
Experience in Denial Management, Utilization Review, Case Management or related experience. Provides expert application of evidence-based medical necessity...
6 days ago - save job - email - more...

Quality Improvement Auditor (Clinical)

Centene Corporation 154 reviews - Sacramento, CA
Assess provider performance and quality of care through clinical case reviews. Lead case reviews to assess the clinical performance provided in the provider...
21 days ago - save job - email - more...

Information Technology Manager

StudentsFirst - Sacramento, CA
Promotes optimal utilization of technology; The application process may include a resume review, phone interview, assignment and in-person/ Skype interviews....
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1 day ago - save job - email - more...

AGD RN

Blue Shield of California 130 reviews - El Dorado Hills, CA
Concurrent or retrospective utilization review denials of inpatient or outpatient care by internal or delegated entities....
30+ days ago - save job - email - more...

Sr. Medicaid Fraud Analyst

Xerox 2,564 reviews - West Sacramento, CA 95691
Identify aberrant billing patterns through utilization reviews. Ability to review claims for medical necessity, utilization, and level of care to identify...
Xerox Corporation - 6 days ago - save job - email - more...

Supervisor - Neurodiagnostic Services / Sleep Disorders Cent...

Sutter Health 169 reviews - Sacramento, CA
Planning and Time Utilization:. Coordinates monthly staff case review with Medical Directors. Thoroughly reviews a patients chart and questionnaire before...
6 days ago - save job - email - more...

Opportunity to Help Transform Healthcare

Alignment Healthcare - Sacramento, CA
Conference call with Case Managers to review patients, and discuss the discharge needs and plans. The program reduces readmission rates and leads to a lower...
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23 days ago - save job - email - more...
(RN) Manager, Utilization Management
- Rancho Cordova, CA
John Dayton, Utilization Review LVN. Clinical claims review experience highly desired. This position has oversight responsibility to plan, develop, and direct...
Sponsored by Miracle Workers - 23 days ago
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