- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager /Director, the Supervisor of Utilization Management is responsible ... Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management...accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred… more
- Sutter Health (Sacramento, CA)
- …+ Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Care at Home - Valley **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more
- ERP International (Mcclellan, CA)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN ) Case Manager ** for a full-time position supporting the **McClellan VA Medical ... consideration for the goals and objectives of the MTF's Utilization Management and Medical Management ...of the following certifications: American Nurses Credentialing Center (ANCC), Nurse Case Manager ( RN -NCM), National… more
- Sutter Health (Sacramento, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... + Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** +… more
- Dignity Health (Rancho Cordova, CA)
- …performing team. - Bachelors Degree in Nursing field (BSN). - Clear and current CA Registered Nurse ( RN ) license and Certified Diabetes Care and Education ... in care and service. **Responsibilities** In this role, the Manager will lead and grow the division to improve...programs and processes to provide patient care around diabetes management . Achieves the Diabetes Program goals and objectives by… more
- Amergis (Sacramento, CA)
- $2598.00 / week The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of ... for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in...of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in… more
- Sharecare, Inc. (Sacramento, CA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM).… more
- Actalent (Sacramento, CA)
- …Skills: + Acute care + Concurrent review + Home health + Health plan + Utilization review + Utilization management + Interqual Additional Skills & ... or claim denial. + The Medi-Cal Appeals and Grievances senior RN will report to the Appeals and Grievances Manager . + In this role, you will perform accurate and… more
- BrightSpring Health Services (Sacramento, CA)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... of business development & growth, achievement of key performance indicators, management of nursing performance and staff development. Responsibilities * Oversees and… more
- Centene Corporation (Sacramento, CA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... is a remote position.** **Monday-Friday 8am-5pm PST.** **Position Purpose:** Perform care management duties to assess, plan and coordinate all aspects of medical and… more
- J&J Family of Companies (Sacramento, CA)
- …care. The CAR-T Cell Therapy Experience Lead is a member of this account management team, reporting to the Senior Manager , CAR-T Cell Therapy Experience Lead. ... on customer experience in the pharmaceutical industry. Our account management teams support the certified sites who care for...Cell Therapy Manufacturer Home Office or Field Experience + RN license or Advanced Practice degree ( Nurse … more
- CenterWell (Sacramento, CA)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a professional and...Graduate of an accredited school of nursing and current RN state license in good standing OR a graduate… more