Utilization review nurse jobs in Modesto, CA

Description. Conducts utilization review for in house patients and or those members at contracted.. RegistrationDriver's License (California)Registered Nurse License (California)Basic Life..

Job Summary. Conducts utilization review for in house patients and or those members at contracted.. License, Certification, Registration Driver's License (California) Registered Nurse License (California..

Shifts available to work fall within regular clinic hours (Mon Fri, 8 5). The Utilization Review.. years of pediatric nursing experience and prior experience as Utilization Review nurse.Education..

TRB and Associates. is seeking an experienced and motivated plan review engineer with current.. Review building plans and prepare written comment letters on building design submittals. Review plans..

Your RoleThe Commercial Post Service Review team is responsible for clinically reviewing claims that are.. The Commercial Post Service Review RN will report to the Manager, Post Service. In this role you will..

Job Title. Prior Authorizations Registered Nurse (RN) Summary. The UM Prior Authorization Nurse is.. Essential Duties. Review prior authorization referrals for medical necessity, exercising independent..

Position. Utilization Management Nurse Location. REMOTE in CA Duration. 6. Months Contract with possible.. The Medicare Member Appeals and Grievances team is responsible for clinically reviewing member appeals..

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..

P. p style "margin bottom 13px". b Job Title. Nurse Practitioner. b. p. p style "margin bottom 13px.. review outcomes and utilization data, including hospitalizations, and use of specialists to establish..

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..

of patient care and ensuring effective management of visit utilization and control of expenses.. RN Registered Nurse of California BLS Basic Life Support Healthcare Provider DL Valid Drivers License..

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..

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..

The Primary Care Physician also provides direction and support to Nurse Practitioners and other members of the IDT. Essential Job Duties. Provide assessment, planning, primary care, and..

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

Job Title. Nurse Practitioner. Primary Care Provider Job Location. Modesto CA Job Type. Full Time(FTE.. At the direction of the Medical Director, review outcomes and utilization data, including..

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..