Utilization Review Nurse jobs in Redwood City, CA

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Inpatient Utilization Management Nurse
The Inpatient Utilization Management (UM) RN is responsible for conducting on-site and telephonic utilization review of hospitalized members and initiating the...
Outpatient Utilization Management Nurse
The Outpatient Utilization Management (UM) Nurse is responsible for conducting clinical reviews of outpatient authorization requests....

Program Manager, Disease Managment

Blue Shield of California - 308 reviews - San Francisco, CA 94105 (Financial District area)
Review externally and internally produced reporting critically and for consistency. Produce relevant reports on process metrics, utilization metrics and cost...

Inpatient Utilization Management Nurse

Alameda Alliance for Health - 16 reviews - Alameda, CA
The Inpatient Utilization Management (UM) RN is responsible for conducting on-site and telephonic utilization review of hospitalized members and initiating the...

Social Worker III - Social Worker/Discha...

County of San Mateo - 12 reviews - San Mateo County, CA
$34.94 - $43.66 an hour
Appropriate utilization of a variety of social resources. An effective communicator to a broad range of stakeholders, including MD's, nurses, conservators,...
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Outpatient Case Management RN

Alameda Health Consortium/Community Health Center... - San Leandro, CA
Active, unrestricted, California Nursing License (Registered Nurse). Identify barriers to efficient hospital utilization and facilitate resolution....

Quality Review Nurse (RN)

San Francisco Health Plan - 11 reviews - San Francisco, CA 94103 (South Of Market area)
Reviews clinical quality processes and identifies workflow enhancements. Reviews, tracks, documents, and manages clinical appeals and grievances....

Patient Services Representative - SR 17-45

Hill Physicians Medical Group - 13 reviews - Oakland, CA
Review ED utilization reports, reaching out to patients as appropriate with high emergency department utilization....

Care Coordinator

Cardinal Health - 1,837 reviews - San Francisco, CA 94102 (Downtown area)
Complete Utilization Management functions for authorizations. The health care team includes physicians, health plan UM/CM Nurse, hospital discharge planners,...

Case Manager/Care Manager (RN)

Seton Medical Center - 6 reviews - Daly City, CA
One year case management or utilization review experience preferred. Current and Valid License in the State of California as a Registered Nurse....

Nurse Care Advocate

Landmark Health - 7 reviews - South San Francisco, CA
1-2 years of utilization management experience a must. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care...

Assistant Clinic Manager, LVN - Internal Medicine

Stanford Health Care - 210 reviews - Palo Alto, CA 94305
Reviews and signs off on daily clinic deposits. Assists the Clinic Manager in interviewing, hiring, orienting, training, and evaluating the competency of...
Home Health RN Manager of Clinical Practice - 10,000 Sign on...
Kindred At Home - 109 reviews - San Rafael, CA 94901
Admissions Nurse, Admission Nurse, BSN, cardio nurse, cardio RN, cardio registered nurse, cardiac nurse, cardiac RN, cardiac registered nurse, case management,...
Utilization Review Specialist- Oakland, CA
BHR Corporation - Oakland, CA
The Utilization Review Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices and discharge planning according...
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Nurse Care Advocate
Landmark Health - 7 reviews - South San Francisco, CA 94080
1-2 years of utilization management experience a must. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care...
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