TravSource is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Arcata, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 10/26/2026 Duration: 13 ...

: 8 hours, days Employment Type: Travel Description In this remote role, you will conduct utilization reviews...

criteria, and annotation best practices. General Job Profile - Reviews the work of others. - Develops innovative approaches...

Description Providence Queen of the Valley Medical Center is committed to delivering top-notch healthcare, earning recognition from the Association of California Healthcare Districts (ACHD) Award in recognition of our outstanding contribu...

required for highly-complex and/or escalated reviews, and providing expert guidance to team members and partnering with the health care... and/or escalated reviews, and providing expert guidance to team members and partnering with the health care team, members...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with in 1979, the Valley Health System has grown to include , , , Benefit Hig...

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the.... Key Details: Must reside in est time zone. Performs concurrent reviews of member for appropriate care and setting...

to perform the function of Technical Reviewer in the ACP Technical Review Unit. The Technical Reviewer will perform reviews... of applicant submissions for asbestos removal and perform related inspections, as necessary. These reviews will help address the...

Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services... prior authorization reviews related to BH to determine medical appropriateness in accordance with ABA regulatory guidelines...

job-related tasks other than those specifically presented in this description. Reviews building permit plans/applications...

referrals. The Clinical Quality Reviewer will conduct comprehensive quality reviews, evaluate clinical concerns, determine... to apply clinical judgment during complex case reviews Behavioral health experience preferred for occasional support needs Preferred...

: Conduct utilization reviews of patient records to assess medical necessity and appropriateness of care. Collaborate...

be requested to perform job-related tasks other than those specifically presented in this description. Reviews building plans... written correction notices. Reviews applications/plans for Land Development Code compliance. Evaluates permit applications...

Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being.... Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. Reviews...

authorizations, pre-certifications, concurrent reviews, and continued-stay reviews. Support medical necessity using ASAM, LOCUS...-to-peer reviews. Track authorized units, coverage dates, and payer deadlines. Collaborate with clinical and admissions teams...

conducting admission criteria assessments, benefits eligibility reviews, care coordination, concurrent and continued stay reviews... patients. Perform care coordination and utilization reviews including concurrent, continued stay, pre-certification, prior...

Performs concurrent reviews of members for appropriate care and setting to determine overall health and appropriate level... of care Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay...

Product Teams (IPT) and participate in design reviews. Represent the engineering community in the build through postproduction...

as perform needed case reviews based on Federal, State and National guidelines. With the Quality, Safety and Risk caregivers...