Utilization Review jobs in Sacramento, CA

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Utilization Review RN
Dignity Health - 705 reviews - Rancho Cordova, CA 95670
This position will review medical records, benefit, contractual and other guidelines to determine benefit coverage, medical appropriateness including, access,...
Prior Authorization Nurse I LVN or RN
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
Case Manager, Disease Management Program RN - Diabetes/CDE
Sutter Health - 460 reviews - Sacramento, CA
Must have strong clinical assessment and critical thinking skills necessary to provide utilization review/discharge planning services appropriate to patients...

Utilization Review Nurse LVN Partially Remote from Home

Medix - 68 reviews - Sacramento, CA
Utilization Review experience. The Utilization Review nurse will complete inpatient admission and concurrent reviews for medical necessity....

Provider Relations Specialist, Bill Review

EK Health Services - Sacramento, CA
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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Utilization Review Specialist

UC DAVIS HEALTH SYSTEM - 109 reviews - Sacramento, CA
The Utilization Review Specialist is to perform assessments of clinical information to determine medical necessity for the identified level of care, assessment...

Nurse Medical Mgmt Job Family, I or II, Sacramento, CA

Anthem, Inc. - 2,164 reviews - Sacramento, CA
Conducts precertification for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility...

Clinical Documentation Improvement Specialist

UnitedHealth Group - 5,560 reviews - Sacramento, CA 95828
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...

Utilization Review Nurse I (Field Based)

Federal Services - 457 reviews - Rancho Cordova, CA
The Utilization Review Nurse I provides first level clinical review for all outpatient and ancillary services requiring authorization....

Quality Improvement Coordinator II

California Health & Wellness - 457 reviews - Sacramento, CA
Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits....

Fleet Management Technician

City of Sacramento - 65 reviews - Sacramento, CA
$25.82 - $36.49 an hour
Review mileage and utilization records as required. Fleet equipment acquisition, utilization and disposal. Incomplete supplemental questionnaires will not pass...

Patient Care Coordinator Case Manager

Kaiser Permanente - 4,942 reviews - Sacramento, CA
Performs daily pre-admission, admission, and concurrent utilization reviews using guidelines, institutional. Minimum two (2) years of experience in utilization...

Quality Improvement Auditor (Clinical) CA-Sacramento

California Health & Wellness - 457 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...
Medical Director
Provide utilization review of medical charts, especially those corresponding to patients seen by part-time staff....
Cedar Point Recovery - Sacramento, CA
Experience with manage care documentation and utilization review a major plus. Full-Time MFTi / ASW / CADAC-II Clinician....
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