Senior Utilization Management Nurse

About the RoleWe are seeking a highly skilled Senior Utilization Management Nurse to join our team at Blue Shield of California. As a key member of our Utilization Management team, you will play a critical role in ensuring our members receive high-quality, cost-effective care.Key ResponsibilitiesConduct prospective utilization reviews and first-level...

Job Title: Utilization Management Nurse, Senior CalPERSAt Blue Shield of California, we are committed to ensuring all Californians have access to high-quality healthcare at a sustainably affordable price. We are seeking a skilled Utilization Management Nurse, Senior CalPERS to join our team.About the RoleThe Commercial Post Service Review team is responsible...

Position OverviewThe Utilization Management department is responsible for evaluating inpatient admissions for our members, adhering to established standards of care. The Senior Utilization Management Nurse will work under the guidance of the Utilization Management Nurse Manager. This role involves assessing clinical data from various inpatient facilities to...

About the RoleThe Utilization Management Nurse, Senior will play a critical role in ensuring the quality and appropriateness of care for our members. As a key member of the Utilization Management team, you will be responsible for reviewing inpatient stays to determine medical necessity and level of care.Key ResponsibilitiesPerform prospective utilization...

About the RoleWe are seeking a highly skilled Utilization Management Nurse, Senior to join our team at Blue Shield of California. As a key member of our Utilization Management team, you will play a critical role in ensuring our members receive high-quality, cost-effective care.Key ResponsibilitiesPerform prospective utilization reviews and first-level...

About the RoleWe are seeking a highly skilled Utilization Management Nurse, Senior to join our team at Blue Shield of California. As a key member of our Utilization Management team, you will play a critical role in ensuring our members receive high-quality, cost-effective care.Key ResponsibilitiesPerform prospective utilization reviews and first-level...

About the RoleThe Utilization Management Nurse, Senior will play a critical role in ensuring that members receive high-quality, cost-effective care. This position will be responsible for performing first-level determination approvals for members using evidence-based guidelines, policies, and nationally recognized clinical criteria.Key ResponsibilitiesPerform...

About the RoleWe are seeking a highly skilled Utilization Management Nurse to join our team at Blue Shield of California. As a key member of our Utilization Management team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care.Key ResponsibilitiesConduct thorough reviews of inpatient stays to...

Your RoleAs a Utilization Management Nurse, you will play a critical role in ensuring that our members receive the highest quality care while minimizing unnecessary costs. You will be responsible for reviewing inpatient stays and applying nationally recognized levels of care guidelines to determine medical necessity.Your WorkConduct thorough reviews of...

Your RoleAs a key member of the Utilization Management team at Blue Shield of California, you will play a critical role in ensuring our members receive the most appropriate and cost-effective care.Reporting to the Utilization Management Nurse Manager, you will be responsible for reviewing inpatient stays for our members and applying nationally recognized...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse to join our team at Blue Shield of California. As a key member of our Commercial Post Service Review team, you will play a critical role in ensuring the accuracy and timeliness of clinical reviews for the CalPERS population.Key ResponsibilitiesPerform thorough and timely clinical reviews...

About the RoleWe are seeking a highly skilled and experienced Director, Commercial Utilization Management to join our team at Blue Shield of California. This critical role will play a key part in the success of our Utilization Management department in achieving its goals and objectives.Key ResponsibilitiesDevelop and implement effective utilization...

About the RoleWe are seeking a highly skilled and experienced Director, Commercial Utilization Management to join our team at Blue Shield of California. This critical role will play a key part in driving the success of our Utilization Management department and contributing to the organization's goals and objectives.Key ResponsibilitiesDevelop and implement...

About the RoleThe Director of Medicare and Medi-Cal Utilization Management will play a critical role in the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives.Key ResponsibilitiesDevelop and implement utilization management strategies to ensure timely and cost-effective care for patients.Lead...

About the RoleWe are seeking a highly experienced and skilled Director, Medicare & Medi-Cal Utilization Management to join our team at Blue Shield of California. This critical role will play a key part in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal membership.Key...

Job SummaryBlue Shield of California is seeking a highly skilled Medical Director, Utilization Management to join our team. As a key member of our Medical Management department, you will play a critical role in ensuring our Medi-Cal members receive the right level of care, at the right time, and at the right cost.The ideal candidate will have a strong...

Senior Wealth Management SpecialistAt Franklin Templeton, we're driving our industry forward by developing innovative solutions to help our clients achieve their investment goals. Our dynamic and diversified firm spans asset management, wealth management, and fintech, offering a range of ways to help investors make progress toward their goals.Key...

About the RoleWe are seeking a highly skilled Medical Director, Utilization Management to join our team at Blue Shield of California. As a key member of our Medical Management department, you will play a critical role in ensuring our members receive the right level of care, at the right time, and at the right cost.Key ResponsibilitiesReview and make...

Senior Wealth Management SpecialistAt Franklin Templeton, we're driving our industry forward by developing innovative solutions to help our clients achieve their investment goals. Our dynamic and diversified firm spans asset management, wealth management, and fintech, offering a range of opportunities to help investors make progress toward their...

Job SummaryWe are seeking a highly skilled Medical Director, Utilization Management to join our team at Blue Shield of California. The successful candidate will be responsible for leading our utilization management efforts, ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesDevelop and implement utilization management...