Healthcare Utilization Specialist

Job Summary:We are seeking a skilled Healthcare Utilization Specialist to join our team at Blue Shield of California. In this role, you will be responsible for conducting clinical reviews, discharge planning, and presenting cases to the Medical Director.About Us:Blue Shield of California is a leading health insurance provider committed to delivering...

Job OverviewWe are seeking a Senior Healthcare Utilization Specialist to join our team at Blue Shield of California.Job SummaryThe Senior Healthcare Utilization Specialist is responsible for reviewing inpatient stays and determining medical necessity in compliance with state and federal regulations. This role involves conducting clinical reviews, discharge...

At CorVel Healthcare Corporation, we're seeking a skilled Healthcare Utilization Review Specialist to join our team. This role plays a crucial part in ensuring the highest quality patient care while maintaining efficient cost management.

About the RoleWe are seeking a skilled Utilization Management Nurse, Senior to join our team at Blue Shield of California. In this role, you will conduct clinical reviews to assess the medical necessity of inpatient admissions and length of stay, ensuring compliance with regulations.

Job SummaryBlue Shield of California is seeking a highly skilled and experienced Strategic Director of Healthcare Utilization to lead our Commercial Utilization Management team. In this critical role, you will play a key part in realizing the department's goals and objectives, while ensuring that patients receive timely and cost-effective care.Key...

**Overview**At Blue Shield of California, we are committed to delivering exceptional healthcare services. We are seeking a highly skilled Medical Director, Utilization Management Specialist to join our team.**Salary Range**The estimated salary range for this role is $165,990.00 - $248,930.00 per year, based on experience and location.**Job Description**As a...

Company Overview">Blue Shield of California is a leading health insurance company dedicated to providing high-quality healthcare services to its members. The organization values innovation, excellence, and teamwork in achieving its goals.Job Summary">We are seeking an experienced Healthcare Executive Director for Utilization Management to lead our team in...

About the RoleWe are seeking a seasoned healthcare professional to lead our Utilization Management team at Blue Shield of California. As Senior Healthcare Manager, Utilization Excellence, you will play a critical role in ensuring our members receive timely and cost-effective care.Key ResponsibilitiesStrategic Leadership: Develop and implement utilization...

Job OverviewThe ideal candidate will possess strong communication and organizational skills, with a proven track record of providing exceptional patient care. As a key member of our team, you will be responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients.Key Responsibilities:• Develop and...

Job OverviewWe are seeking a skilled Occupational Therapist to join our team at TheraEx Therapy in Rancho Cordova, California.Salary and BenefitsThe pay package for this position is based on 8 hour shifts and 40 hours per week. The tax-free stipend amount will be determined accordingly.Job DescriptionAs a Mobile Healthcare Specialist, you will provide...

At Blue Shield of California, we are dedicated to providing exceptional care management services to our members. We are seeking a highly skilled and compassionate Healthcare Specialist - Care Management to join our team.About the RoleThis role will be responsible for ensuring that our members receive high-quality, cost-effective healthcare services. You will...

**Job Overview**Rite Aid seeks a highly skilled and dedicated Regional Pharmacist to join our team. This role is an excellent opportunity for individuals who are passionate about delivering exceptional patient care and making a positive impact on the healthcare landscape.The successful candidate will be responsible for assisting customers with their...

Your RoleAs a Senior Manager of Utilization and Care Coordination at Blue Shield of California, you will play a critical role in realizing the company's goals and objectives. This position is key to the success of the Utilization Management department and requires an individual who can provide direction and leadership in compliance with regulatory...

Job OverviewKPG Healthcare is a leading provider of healthcare staffing solutions, seeking a dedicated Critical Care Nurse Specialist to join our team in Rancho Cordova, California.About the RoleThis 13-week contract offers an exciting opportunity to work in a dynamic ED - Emergency Department setting. As a Critical Care Nurse Specialist, you will be...

Job SummaryIn this challenging and rewarding role as a Senior Utilization Management Nurse at Blue Shield of California, you will be responsible for reviewing inpatient stays to ensure medical necessity in compliance with state and federal regulations. Your expertise in clinical review, discharge planning, and presenting cases to the Medical Director will...

Job OverviewCure Healthcare Staffing is seeking a travel nurse to join our team in Rancho Cordova, California.This 13-week assignment offers the opportunity to work in a dynamic emergency department environment, providing high-quality patient care and collaborating with a skilled healthcare team.About the RoleSpecialty: Emergency DepartmentDiscipline:...

Experience a fulfilling career with SkyBridge Healthcare Therapy as a Mobility Specialist for Therapeutic Services. This exciting opportunity is available in Cordova, Alaska.About the JobWe are seeking a highly skilled Physical Therapist to join our team. As a Mobility Specialist for Therapeutic Services, you will work closely with patients to develop and...

Job SummaryWe are seeking a seasoned Healthcare Operations Director to oversee Utilization Management and care coordination for Medicare and Medi-Cal beneficiaries at Blue Shield of California. As a key member of our team, you will be responsible for managing prior authorization processes, developing UM strategies using data analytics, and ensuring...

About This OpportunityTheraEX Staffing Services is a leading healthcare staffing provider, and we are seeking an experienced Medical Travel Nurse Specialist for a 13-week contract in Rancho Cordova, California.This role involves working in a Med Surg environment with a focus on patient transfers, requiring strong clinical skills and the ability to work...

Job Title: Travel Nurse Clinical SpecialistOverview of the RoleWe are seeking a dedicated and skilled travel nurse to join our team as a clinical specialist in a clinic setting. This exciting opportunity allows for professional growth and development while making a meaningful impact on patient care.The successful candidate will possess excellent clinical...