RN Utilization Manager - Bakersfield, CA

The RN Utilization Manager is responsible for reviewing and coordinating healthcare service requests to ensure they meet clinical and regulatory standards. · Evaluating medical necessity of referrals and authorizations. · Applying clinical guidelines (e.g., Medicaid, Milliman cri ...

Bring your skills into the future with a career in industrial utilities and sustainable operations. This position is for a Plant Manager – Utilities & Operations in Bakersfield, CA. · ...

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. The reviewer will engage in peer-to-pe ...

As the Utilization Management (UM) Physician Reviewer, · ...

The Utilization Management (UM) Physician Reviewer will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. · ...

The RN Utilization Management Nurse performs review of requested outpatient and elective prospective inpatient medical services under the direction of the UM Clinical Supervisor coordinates and refers KHS members for services which are carved out of KHS medical coverage assists i ...

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. · ...

The UM Clinical Manager is responsible for reviewing Utilization Management policy and guidelines to ensure staff compliance with policies. · Perform audits on various project reports, Notice of Action notifications, and referrals for compliance. · ...

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organizat ...

The Assistant Project Manager is responsible for the administration of the construction project, · Able to perform all Project Engineer job responsibilities · Maintain cost control ledger and job cost statements · ...

The Senior Project Manager is responsible for the overall management of construction project resulting in successful project completion. · ...

The Assistant Project Manager is responsible for the administration of the construction project, · assisting the Project Manager in management of the construction project. · This position will be based onsite in California or Nevada.Employees (and their families) are eligible for ...

The Clinical Auditor and Trainer RN is responsible for reviewing Utilization Management policy and guidelines to ensure staff compliance.The purpose of this position is to provide support to the UM Management team for auditing and analytics of the UM authorization process. · ...

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The UM Clinical Manager is responsible for reviewing Utilization Management policy and guidelines to ensure staff compliance with policies. · Perform audits on various project reports, Notice of Action notifications, and referrals for compliance, · Provide recommendation for proc ...

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organizat ...

As a Utilization Management RN, you will be crucial in ensuring accurate and compliant medical necessity decisions. · Reviewing medical records · Authorizing services · ...

As a Utilization Management RN you will be crucial in ensuring accurate and compliant medical necessity decisions. · Reviewing medical records authorizing services preparing cases for physician review · Closely working with both Pre-Service In-Patient Utilization Management teams ...

The Vegetation Program Manager oversees Vegetation Management operations, ensuring electric system safety, reliability, and regulatory compliance with state and federal rules. · ...

As a Utilization Management RN you will be crucial in ensuring accurate and compliant medical necessity decisions.Reviewing medical records. · Authorizing services. · ...