Cherokee Federal
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Travis Afb,CA
Shall read, understand, speak, and write English fluently. - Shall have knowledge, skills, and computer literacy to interpret and apply medical care criteria, such as, but not limited to, Inter. Qual or Milliman Ambulatory Care Guidelines. - Shall...
Disability Solutions
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Concord,CA
Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring,...
John Muir Health
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Concord,CA
Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring,...
Cherokee Federal
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Fairfield,CA
This position requires an active Public Trust clearance or the ability to obtain a Public Trust clearance to be considered. As required by our governmental client, this position requires being a US Citizen. Accurately advises...
BlueCross BlueShield of South Carolina
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Fairfield,CA
Summary We are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South Carolina. In this role as a Quality nurse Navigator, you will monitor/implement quality improvement/management activities,...
Catholic Hospice
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Fairfield,CA
Per-Diem Hours: Sundays 12am to 8am Summary & Objective The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care...
RYZ Labs
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Fairfield,CA
A healthcare company is seeking a Registered Nurse to provide home care services to patients. In this role, you will assess and evaluate patient needs, implement care plans, and monitor patient progress. Candidates must hold a valid RN license and...
Houston Methodist Hospital
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Fairfield,CA
At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally...
Stanford Health Care
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Fairfield,CA
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This...
Disability Solutions
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Concord,CA
Job Description:Based on John Muir Health Nursing's Vision of being the innovative leader for the professional role of the registered nurse. Through evidence-based practices and relevant patient care models, the nursing culture...
Blue Cross Blue Shield of Arizona
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Fairfield,CA
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...
BlueCross BlueShield of Tennessee
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Fairfield,CA
Join our team as a Clinical Review Manager! We are seeking a quick learner who is self-motivated and capable of working independently. The ideal candidate will be able to efficiently navigate and disseminate clinical information in a...
Sentara Healthcare
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Fairfield,CA
City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara Health is now hiring an Ambulatory Integrated Care Manager for Pediatric care! Hours:...
Health Care District
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Fairfield,CA
Job Description Leads nursing and medical operations in crisis stabilization and emergency psychiatric settings, ensuring delivery of safe, high-quality, trauma-informed care. Oversees nursing personnel, medication...
Partnership HealthPlan of California
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Fairfield,CA
Overview To work with a dedicated and committed team, the RN Quality Investigator I is responsible for assessing and improving the quality of care provided by the providers serving our members.
Martin's Point Health Care
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Fairfield,CA
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...
Pacer Group
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Fairfield,CA
Job Profile Summary Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to...
Berkley
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Fairfield,CA
Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...
Qlarant
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Fairfield,CA
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health,...
CareSource
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Fairfield,CA
Job Summary: The Clinical Appeals Nurse is responsible for processing clinical appeals and attending state hearings within compliance and regulatory standards, clinical guidelines, and contractual obligations. Essential...
Hireops Staffing Llc
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Fairfield,CA
JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...
Inspire Hospice & Palliative Care
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Fairfield,CA
Join the Inspire Hospice Team - Remote Triage Nurse Opportunity Are you a compassionate RN looking to make a meaningful impact-without leaving home? Inspire Hospice and Palliative Care is seeking a dedicated,...
Kansas Staffing
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Fairfield,CA
divh2Job Opportunity At Highmark Inc./h2pJob Summary: This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,...
