Utilization Review Nurse jobs in Palo Alto, CA

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AHD Nurse, Care Management
Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and...
Nurse Case Manager - Field
EK Health Services - San Jose, CA 95129
EK Health Services has built a reputation for offering superior, goal-oriented Workers' Compensation case management, utilization review, and bill review...
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Temp UM Nurse

Santa Clara Family Health Plan - 11 reviews - Campbell, CA 95008
Knowledge of Milliman/MCG guidelines or other nationally accredited utilization review criteria or standards....

Cosmetic Services/Cosmetic Dematology Patient Care Coordinat...

Kaiser Permanente - 5,803 reviews - San Jose, CA
Demonstrated experience in utilization management, discharge planning, or transfer coordination. Please be aware that this position is currently under review as...

Nurse Liaison, Health Homes and Whole Person Care

Alameda Alliance for Health - 21 reviews - Alameda, CA
Active California Registered Nurse License, Nurse Practitioner. Audit and review CB-CME processes, documents, and measures for completion and quality....

Clinical Improvement Manager

Satellite Healthcare - 33 reviews - San Jose, CA
Registered Nurse license; Review quality measures monthly/quarterly for assigned territory; Review deficient findings with Center management and Territory/Home...

Case Manager

Good Samaritan Hospital - 907 reviews - San Jose, CA
The Case Manager is responsible for utilization review and discharge planning for assigned patient population....

Case Manager - Utilization Management (1.0 FTE, Days)

Lucile Packard Children's Hospital - 82 reviews - Palo Alto, CA 94304
Performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services;...

Quality Improvement Nurse Specialist

Alameda Alliance for Health - 21 reviews - Alameda, CA
Facility Site Review:. Conduct scheduled Facility Site Reviews. The QI Nurse Specialist prepares cases and presents potential quality care issues to the Medical...


ST. ROSE HOSPITAL - 35 reviews - Hayward, CA 94545 (Glen Eden area)
 Tracks and monitors inappropriate resource utilization. As part of the team, makes decisions regarding utilization management and alternative treatment which...

Director Inpatient Psychiatric Clinical Services

Kaiser Permanente - 5,803 reviews - Santa Clara, CA
KP conducts compensation reviews of positions on a routine basis. W/ TPMG partner, directs development & implementation of quality & utilization standards...

Clinical Sourcing Manager

Stanford Health Care - 261 reviews - Palo Alto, CA 94305
Conducts reviews of supplier relationships (conduct performance reviews, gather stakeholder input, amass data, etc.)....
Registered Nurse Case Manager
American Nurses Credentialing Center, Nurse Case Manager (RN-NCM). Registered nurse, RN, medical management, discharge planning, utilization review, case...
Complex Case Manager, RN or LVN
Excel MSO, LLC - San Jose, CA 95113
Performs concurrent, prior authorization and retrospective reviews according to established policies, procedures, and review guidelines....
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Utilization Management Review Nurse
Chinese Hospital - 6 reviews - San Francisco, CA 94133
Utilization Management Nurse Reviewer. The Nurse reviewer performs on-site, written or telephonic assessments and utilization review, across the continuum of...
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