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...
Care Transitions Manager
Must reflect appropriate knowledge of RN scope of practice, current state requirements, CMS Conditions of Participation, EMTALA, The Patient Bill of Rights,...

Assistant Clinic Manager, LVN - Internal Medicine

Stanford Health Care - 209 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...

Temp Concurrent Review Nurse/Behavioral Health CM

Santa Clara Family Health Plan - 7 reviews - Campbell, CA 95008
Review and expedite any other home care requirements. Concurrent review of all psychiatrically hospitalized patients for appropriateness per Milliman guidelines...

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....

Cancer Survivorship Case Manager RN 40/hr

Kaiser Permanente - 4,782 reviews - Santa Clara, CA
This review is on a position-by-position basis and includes an analysis of the actual duties performed in each position under review....

RN Supervisor (on-call)

Jewish Home San Francisco - San Francisco, CA
Conducts performance reviews for nursing personnel on assigned shift in conjunction with Charge Nurse. Maintains and ensures effective staff utilization....
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Care Advocate - Assess and Triage

UnitedHealth Group - 5,358 reviews - San Francisco, CA
Administer benefits and review treatment plans. Take this opportunity to start doing your life's best work.(sm) As an Assess and Triage Care Advocate you will...

Care Management Nurse

San Francisco Health Plan - 11 reviews - San Francisco, CA 94103 (South Of Market area)
Nurse case management includes medical assessment and care planning, chronic condition teaching aimed at self-management, and post-discharge follow-up...

Nurse Case Manager - Field

EK Health Services - San Jose, CA 95129 (West San Jose area)  +1 location
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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Care Coordinator

naviHealth - 26 reviews - San Francisco, CA
Complete Utilization Management functions for authorizations. The health care team includes physicians, health plan UM/CM Nurse, hospital discharge planners,...

Supervisor, Clinical Nurse

Landmark Health - 7 reviews - South San Francisco, CA
These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers,...
Clinical Documentation Improvement Specialist - $5K Sign on...
UnitedHealth Group - 5,358 reviews - San Francisco, CA
Provides expert level review of inpatient clinical records within 24-48 hours of admit; Ensures effective utilization of Midas or Optum ® CDI 3D Technology to...
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...
Utilization Review Nurse
Healthcare Scouts - 20 reviews - South San Francisco, CA
We are seeking full time Utilization Review Nurse! At Least 1 year utilization review or case management experience....
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