RN Utilization Review jobs in Sacramento, CA

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HH Pediatric RN Per Diem
UC DAVIS HEALTH SYSTEM 65 reviews - Sacramento, CA
Participating in utilization review, quality assessment and performance improvement activities and policy development related to patient care;...
Sponsored by UC DAVIS HEALTH SYSTEM
Utilization Review Nurse (Outpatient)
River City Medical Group - Sacramento, CA
Responsible for working directly with the Medical Director to review and properly address requests that need higher level of review, such as CCS possible cases,...
Easily apply
Sponsored by River City Medical Group
Case Manager, Grievance Clinical Lead
Partnership HealthPlan of California 11 reviews - Fairfield, CA
Reviews responses written by PHC’s Grievance Coordinator for State Hearings or for Medicare review entities....
Sponsored by Partnership HealthPlan of California

RN Care Coordinator

Mercy Healthcare Sacramento 564 reviews - Sacramento, CA
The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required by hospital policies, standards of...

Medical Case Management Nurse

Benefit and Risk Management Services - Folsom, CA
Provides statistical case reviews and generates utilization reports. Current California RN License:. Documents review information in computer....

Nurse Medical Management I/II Job Family - Northern Californ...

Anthem, Inc. 626 reviews - Sacramento, CA
Current unrestricted California RN license required. Knowledge of the Continued stay review process is required....

Case Manager RN - Telephonic Disease Management Program

Sutter Health 241 reviews - Sacramento, CA
Current California RN Licensure required. Must have strong clinical assessment and critical thinking skills necessary to provide utilization review/discharge...

Outpatient Utilization Review Nurse (LVN/RN)

River City Medical Group - Sacramento, CA
Responsible for working directly with the Medical Director to review and properly address requests that need higher level of review, such as CCS possible cases,...

Outpatient Utilization Review Nurse - Direct Hire

Pacific Staffing 26 reviews - Sacramento, CA
The ideal candidate will be a skilled LVN or RN with previous experience in utilization review or case management....

Claims Utilization Review Nurse (LVN/RN)

River City Medical Group - Sacramento, CA
Act as back up for Prior Authorization Review Nurses when needed. Must be a licensed RN or LVN within the State of California....
Easily apply

Utilization Review Nurse (Outpatient)

River City Medical Group - Sacramento, CA 95831 (Greenhaven area)
Responsible for working directly with the Medical Director to review and properly address requests that need higher level of review, such as CCS possible cases,...
Easily apply

RN Case Manager - Roseville, Emergency Dept (Full time-Varie...

Sutter Health 241 reviews - Roseville, CA  +1 location
Current California RN Licensure required. Must have strong clinical assessment skills necessary to provide utilization review and transition planning services...

RN Clinical Quality Audit Analyst Sr - Northern CaliforniaSY

Anthem, Inc. 626 reviews - Rancho Cordova, CA
Seeking a RN with 2 years experience in quality improvement, risk management and/or utilization review in a managed care setting with knowledge of NCQA and...
Clinical Review Clinician III/ Utilization Review RN-(Teleco...
Molina Healthcare 158 reviews - Sacramento, CA
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review....
Sponsored by Molina Healthcare
Inpatient Case Manager (LVN/RN)
River City Medical Group - Sacramento, CA
Will be required to review Requests for Authorizations and approve and/or refer to Medical Director/Chief Medical Officer for review and denial....
Easily apply
Sponsored by River City Medical Group

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