Utilization Review RN - Case Review Specialist
Canon Recruiting Group
Canon Recruiting Group is hiring an RN / Utilization Review Nurse for a potential contract to hire position in Sacramento, CA. This role involves reviewing medical records and treatment requests to ensure compliance with guidelines and provide timely care decisions. Applicants must have an active LVN license and at least 3 years of clinical experience. Strong communication and organizational skills are essential. The position offers a pay range of $35.00 – $45.00/hour, paid weekly, with Monday to Friday schedules. #J-18808-Ljbffr Canon Recruiting Group
$35 - $45 per hour
Canon Recruiting Group is seeking an experienced RN / Utilization Review Nurse in Sacramento, CA. The role involves reviewing medical records and treatment requests, ensuring compliance with clinical guidelines, and collaborating with internal teams. Candidates should have...SuggestedContract work$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.0... ...internal teams, providers, and physician reviewers to support case review processes. Assist with coordination of peer...SuggestedWeekly payContract workWork at officeRemote workMonday to Friday$35 - $45 per hour
Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $35.00 - $45.0... ...internal teams, providers, and physician reviewers to support case review processes. Assist with coordination of peer reviews...SuggestedWeekly payContract workWork at officeRemote workMonday to Friday$90.86k - $136.29k
...Job Title Utilization Management Concurrent Review Nurse Job Description The Utilization Management Concurrent... ...DC planning Prepare and present cases to the Medical Director for medical... .... Requires a current California RN License Requires at least 5 years...SuggestedFull timeContract workWork at officeRemote work- Gilder Search Group is seeking an experienced Utilization Review Nurse for a potential contract to hire position in Sacramento, CA. The role involves reviewing medical records and treatment requests to support timely and compliant care decisions. The ideal candidate will...SuggestedContract work
$54 - $66 per hour
We are recruiting for a Utilization Review Nurse to join a large healthcare organization within the Sacramento region. The Utilization Review... ...application of clinical criteria and accurate preparation of cases for UM Physician Reviewers when indicated. Ensure timely verbal...Contract workWork at office- ...Solutions is seeking a Clinical Review Nurse in Alameda, California.... ...requires an active California RN license. You will handle... ...medical necessity reviews, and utilization reviews. Candidates should have... ...engaging with complex clinical cases. #J-18808-Ljbffr A-Line Staffing...Full time
- ...Your Role The Utilization Management Concurrent Review team reviews the inpatient stays for our members and correctly applies guidelines for nationally... ...degree preferred. Requires a current California RN License Requires at least 5 years of prior relevant...Full timeWork at office
$27.61 - $53.83 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...timelines. • Refers appropriate cases to medical directors (MDs) and presents... ...promote the Molina care model. • Adheres to utilization management (UM) policies and procedures....Hourly payContract workWork experience placementWork at office$110k - $120k
Concurrent Review/Transition of Care Nurse, RN page is loaded## Concurrent Review/Transition of Care Nurse,... ...the care continuum. Monitor inpatient utilization, assist with facilitation of the... ...any issues that may require ongoing case management* Assure member has adequate...Remote work- Licensed Vocational Nurse /LVN - Utilization Review (HEDIS Abstractor) HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical...Private practiceWork at officeMonday to Friday
- A-Line Staffing Solutions is seeking a Clinical Review Nurse for a remote position in California. The role... ..., grievances, medical necessity review, and utilization management. The ideal candidate will be an experienced RN skilled in reviewing complex medical records, applying...Remote job
$54 - $66 per hour
A prominent healthcare staffing agency is seeking a Utilization Review Nurse in Sacramento, CA, responsible for managing the daily operations of the UM Pre-Authorization team. The ideal candidate will ensure accurate processing of referral requests, maintain regulatory...- Position Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member will serve as the QIDP (.5 FTE) and as... ...and forward to a Physician Advisor/Consulting Physician all cases for which a medical necessity determination cannot be...Contract workRemote work
$66 per hour
Clinical Review Nurse Location: Alameda, CA Pay: $66.00/hour Schedule: Full... ...License Required: Active California RN License Hiring Clinical Review... ...grievances, medical necessity review, utilization review, and managed care clinical case evaluation . This role is ideal...Full timeMonday to Friday- ...Medical Case Management Nurse The Medical Case Management Nurse... ...with respect to medical care review, cost containment, claims review... ...case reviews and generates utilization reports Examine DRG pre-certification... ...: Current California RN or LVN License: REQUIRED...Work at office
$33 - $38 per hour
Serenity Knolls is seeking a Full Time On-Site Utilization Review Specialist at our substance use facility located in the beautiful San Geronimo Valley. The role involves monitoring service utilization and ensuring optimal reimbursement. Candidates should possess a high...Hourly payFull time- ...Gurstel Law Firm, P.C. – Associate Attorney-Centralized Document Review JOB SUMMARY We are seeking a detail-oriented Associate... ...jurisdictions. Litigation Support: Provide recommendations based on case law analysis; perform court appearances only as necessary in...Contract workCasual workWork at officeLocal areaFlexible hours
$77.91k - $116.86k
...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient... ...’s primary care physician, facility case manager, discharge planner and... ...active, valid, and unrestricted LVN or RN license in California (Non-Compact)...Immediate startRemote workMonday to Friday$33 - $38 per hour
Overview Serenity Knolls is seeking a Full Time On‑Site Utilization Review Specialist at our substance use facility. Proactively monitor utilization... .../DESIGNATIONS/CERTIFICATIONS: Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC‑I within the state where the facility...Hourly payFull timeWork at office- ...Registered Nurse (RN) Case Manager Community Health Centers of... ...workers, facility nursing staff, specialists, and ancillary service... ...readmissions through chart review, interdisciplinary collaboration... ..., transitional support, utilization of preventive services, and...Full timeWork at office
$60 per hour
...HOSPICE RN CASE MANAGER *** 5k sign on bonus Job details Job Type Full-time... ...terminal illness. The Hospice RN regularly reviews and updates the plan of care. Performs... ...Provides professional nursing care by utilizing all elements of nursing process. Assesses...Full timeRelocation packageMonday to Friday- The Council of State and Territorial Epidemiologists is seeking a Registered Nurse (RN) for a dual role performing Clinical Review work and Quality Improvement Designation Program (QIDP) reviews. The position is primarily remote, requiring reliable internet access, and...Remote job
- Stryker Corporation is seeking an RN for Clinical Review and QIDP reviews, working remotely with a focus on applying Alabama Medicaid criteria to healthcare services. The ideal candidate must have a BA/BS in Nursing and be an active RN in Alabama. Key responsibilities...Remote job
$23 per hour
...Purpose: The Asset Protection Specialist is primarily responsible for... ...store/multiple stores. They utilize tools to minimize loss to the... ...of theft and fraud, reviewing CCTV and exception reports, monitoring... ...accurate and detailed case reports documenting your apprehensions...Local area- ...) Captain in the Allegation Investigation Unit (AIU), the Case Resolution Specialist (non-sworn) identifies, locates and gathers records and evidence... ...required to submit to a background investigation process utilizing Live Scan Fingerprinting, and Tuberculosis testing prior...Permanent employmentWork experience placementWork at officeRemote workWeekend work
- ...Item Processing Specialist The Item Processing Specialist is a seasoned... ...processing efficiently. Utilize various item processing... ...transactions. Conduct thorough reviews of processed transactions to... ...for immediate resolution. In cases where members may be affected...Work at officeImmediate start
$60.93 per hour
...The Disaster Program Delivery Specialist: • Collects, coordinates and/or reviews applicant data to determine eligibility... ...’s Consolidated Resource Centers utilizing a web-based tool, schedules site... ...country statutory law but in no case, will the background check...Full timeContract workTemporary workFor contractorsH1bWork at officeFlexible hours$2,904 per week
...Travel Nurses, Inc. is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description... ...Travel Case Management Salary information and unbiased reviews from leading Travel Nurse Agencies across the United States,...Weekly payImmediate startShift work$2,712 per week
...TRS Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in... ...Management Salary information and unbiased reviews from leading Travel Nurse Agencies... ...therapists, imaging technologists, laboratory specialists, and other experienced nursing and...Shift work
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