Utilization review nurse jobs in Fresno, CA

Are you an experienced Registered Nurse. Senior with a desire to excel? If so, then Talent Software.. Demonstrate the ability to act independently using sound clinical judgment Preferred. Utilization..

Identify opportunities to promote quality effectiveness of healthcare services and benefit utilization. Consult and lend expertise to other internal and external constituents in the coordination..

Provide inpatient case management to patients in a busy medical center. Responsible for utilization review and discharge planning..

Current licensure as a Registered Nurse in the State of California is required. 3. Minimum five (5.. Prior quality improvement and peer review experience is preferred. 7. Experience leading a multi..

Review outcomes and utilization data, including hospitalizations, and use of specialists to establish.. Graduation from an Accredited School of Nursing Certificate as a Nurse Practitioner with Prescriptive..

Job DescriptionA bit about this role. This position interacts with utilization management, clinical.. clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer discussions..

Job Summary. Manages activities of the unit(s), monitors quality, service and utilization standards.. Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser..

Rehabilitation Center of Fresno. Case Manager LVN (Licensed Vocational Nurse) Principal Responsibilities.. Determines resource utilization specific to patient care needs, outcome expectations, payor and Company..

RN Case Manager, Social Services Requisition ID 2024 39964 Category Registered Nurse Shift Type Limited.. Provides concurrent and ongoing review of patient charts based on screening criteria developed and..

Business Administration or Hospital Administration preferredRegistered Nurse requiredDirector of Case.. follow up and documentationImplements and monitors Utilization Review process in place to communicate..

Case Managers and Social Workers on the team, while overseeing all protocol for Case Management, Discharge Planning, and Utilization Review. Reports to the VP Regional executive. California..

Agnes! Position. Registered Nurse, Staff RN Hospital Location. 1303 East Herndon Avenue, Fresno, CA 93720 Unit Openings. Resource. Float Pool. Emergency Department. Labor & Delivery..

And long term placement Provide direction and guidance to Nurse Practitioners Oversee participants' use.. providing regular visits as dictated by PACE standards and participants' needs Review outcome and..

We have an opportunity to join the Alliance as the Utilization Management Manager. Behavioral Health.. Details about this can be reviewed during the interview process. The full compensation range for this..

JOB SUMMARY The Transfer DRG Revenue Review Specialist performs work to capture lost revenue for.. The company has reviewed this job description to ensure that the essential functions and basic duties..

Position summary Responsible to provide professional nurse case management coordination for claimants.. utilization criteria), medical coding mechanisms( ICD 9 CM, CPT 4, DSM IV), case management standards of..

Neurosurgical Associates Medical Group (NAMG) is seeking to hire a Nurse Practitioner Physician.. Collaborate with physicians in managing acute and long term medical needs of patients. Review lab and..

And long term placement Provide direction and guidance to Nurse Practitioners Oversee participants' use.. providing regular visits as dictated by PACE standards and participants' needs Review outcome and..

And long term placement Oversee participants' use of medical specialists and inpatient care Participate in rotating night and weekend call Review outcome and utilization data, including adverse..