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Utilization Management Coordinator
4 weeks ago
Dignity Health Rancho Cordova, United StatesUnder the direction of Utilization Management (UM) leadership, the UM Coordinator processes prior authorization with established criteria. Coordinates In-Patient and SNF process to include referral creation, formation, data entry and ensure UM notifi Coordinator, Management, Heal ...
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Utilization Management Coordinator
3 weeks ago
Common Spirit Rancho Cordova, United StatesOverview Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - wit ...
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Registered Nurse Utilization Management
3 weeks ago
LMG Healthcare Rancho Cordova, United StatesJob Description · Job Description · Job Description · Minimum Qualifications:Registered Nurse (Current and active California RN license in good standing) required. · BSN/BS/BA and/or Masters Degree in Healthcare related field required.Demonstrated track record in managed care (5+ ...
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utilization management coordinator
3 weeks ago
Common Spirit Rancho Cordova, CA , USA, United StatesOverview · Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - w ...
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utilization management coordinator
3 weeks ago
Dignity Health Rancho Cordova, CA , USA, United States**Overview** · Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation ...
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Cornerstone Staffing Solutions Rancho Cordova, United StatesAre you a leader? · A medical professional who leads by proactive example? · Pay Range: $44 -$51 with stipend · Work Schedule: Mon-Sat, 8:00a - 4:30p · We are seeking a medical professional for the role of Supervisor of Utilization Management. · You will be taking on the rol ...
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Cornerstone Staffing Solutions, Inc. Rancho Cordova, United StatesAre you a leader? · A medical professional who leads by proactive example? · Pay Range: $68.00 · Work Schedule: M-Sat, 8:00a - 4:30p · We are seeking a Medical professional for the role of Manager of Utilization Management (UM) is responsible for managing the day-to-day operation ...
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utilization management nurse, consultant
4 weeks ago
Blue Cross and Blue Shield Association Rancho Cordova, CA , USA, United StatesYour Role · The Utilization Management team facilitates the review of requests for medical necessity to assure that care is provided to our members timely, at the correct level of care with quality and cost effectiveness standards. The Utilization Management Nurse Consultant will ...
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RN Supervisor Utilization Management
4 weeks ago
CommonSpirit Health Rancho Cordova, United StatesOverview ***This position is hybrid in-office and work from home. Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Healt ...
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RN Supervisor Utilization Management
2 weeks ago
Dignity Health Rancho Cordova, United States**Overview*******This position is hybrid in-office and work from home.**Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity ...
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Utilization Management Nurse, Senior
4 days ago
Blue Shield Of California Rancho Cordova, United StatesJob Description · Your Role · The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In t ...
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Utilization Management Coordinator
2 weeks ago
Sierra Vista Hospital Sacramento, United States Full timeJob Description · Responsibilities · Sierra Vista Hospital is seeking a full-time Utilization Management Coordinator (MSW, MFT, MA, RN) for the Utilization Management Department. If you're passionate about working in the behavioral health setting and have the desire to join a ...
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Utilities Project Manager
3 weeks ago
TEC Constructors & Engineers Sacramento, United StatesJob Description · Job DescriptionGENERAL STATEMENT: · Under the general direction of the Deputy Director Third Parties and the Utilities – Senior Project Manager coordinates utility work between the Authority, Design Builder, PCM teams and third-party utilities. Develops, builds, ...
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Utility Coordination Project Manager
3 weeks ago
Pennino Management Group Sacramento, United StatesJob Description · Job DescriptionAssists Principals/PM's with delivery of multiple projects for Public and Private sector clients. The general scope of services includes the coordination of dry utilities which typically includes electric, natural gas, and fiber for developments. ...
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program manager, public utilities commission
5 days ago
California Energy Commission Sacramento County, United StatesJob Description and Duties · Under the general direction of the Deputy Director, Building Decarbonization Section of the Reliability, Renewable Energy & Decarbonization Incentives (RREDI) Division, the Program Manager, Public Utilities Commission (PUC) has full management respon ...
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Utilities Assistant Project Manager
3 weeks ago
AECOM Sacramento, United States**Company Description** · **At AECOM, were delivering a better world.** · We believe infrastructure creates opportunity for everyone. Whether its improving your commute, keeping the lights on, providing access to clean water or transforming skylines, our work helps people and c ...
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program manager, public utilities commission
2 weeks ago
State of California Sacramento County, United StatesJob Posting: Clean Energy Infrastructure Branch Manager · California Energy Commission · JC Clean Energy Infrastructure Branch Manager · PROGRAM MANAGER, PUBLIC UTILITIES COMMISSION $14, $16,501.00 per Month · Final Filing Date: 6/1/2024 · Application Methods: Electronic ( ...
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program manager, public utilities commission
1 week ago
California Energy Commission Sacramento County, United StatesJob Description and Duties · Under the general direction of the Deputy Director, Siting, Transmission and Environmental Protection Division, the Program Manager, Public Utilities Commission (PUC) has full management responsibility for the most complex and sensitive program issue ...
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utilization management coordinator
3 weeks ago
Universal Health Services Sacramento, CA , USA, United States Full timeResponsibilities · Sierra Vista Hospital is seeking a full-time Utilization Management Coordinator (MSW, MFT, MA, RN) for the Utilization Management Department. If you're passionate about working in the behavioral health setting and have the desire to join a team of healthcare pr ...
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Director of Utilization Management
4 weeks ago
UHS Sacramento, United StatesResponsibilities · Sierra Vista Hospital is seeking a talented and dynamic Director of Utilization Management to join our team of dedicated healthcare professionals · Located in Sacramento, California, Sierra Vista Hospital is a compassionate behavioral health facility and a ce ...
Registered Nurse Utilization Management - Rancho Cordova, United States - JobRialto
Description
Job DescriptionMinimum Qualifications:
Registered Nurse (Current and active California RN license in good standing) required.
BSN/BS/BA and/or Masters Degree in Healthcare related field required.
Demonstrated track record in managed care (5+ years experience preferred).
Strong supervisory and management skills.
Excellent verbal and written communication and computer skills.
Considerable interpersonal skills
Clinical claims review experience is highly desired.
Knowledge of relevant State and Federal laws, statutes and regulations preferred.
Duties:
Review medical records to ensure appropriateness, quality, and cost-effectiveness of healthcare services.
Evaluate the necessity and efficiency of medical treatments, procedures, and hospital admissions.
Communicate with healthcare providers to gather necessary information for decision-making.
Utilize clinical guidelines and evidence-based practices to assess medical necessity.
Collaborate with interdisciplinary teams to develop and implement care plans.
Monitor patient progress and outcomes to ensure continuity and quality of care.
Identify opportunities for improvement in healthcare delivery and utilization.
Provide education and support to patients, families, and caregivers regarding treatment options and resources.
Document all review activities and decisions according to regulatory requirements.
Participate in utilization review committee meetings to discuss cases and trends.
Stay updated on healthcare regulations, policies, and reimbursement guidelines.
Education: Masters Degree