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Other JobsManager, Utilization Management Nurse Management Description: Your Role The Facility Compliance Review FCR team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never (more...) Company: Blue Shield of California Location: Seal Beach Posted on: 07/15/2025 Licensed Clinician, Senior Description: Your Role The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination approvals for members using BSC evidenced (more...) Company: Blue Shield of California Location: Hawaiian Gardens Posted on: 07/15/2025 Utilization Management Nurse, Senior Description: Your Role The Facility Compliance Review FCR team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never (more...) Company: Blue Shield of California Location: Lakewood Posted on: 07/15/2025 Utilization Management Nurse, Senior Description: Your Role The Facility Compliance Review FCR team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never (more...) Company: Blue Shield of California Location: Stanton Posted on: 07/15/2025 Behavioral Health Utilization Management Clinician, Senior Description: Your Role The Behavioral Health Utilization Management team performs prospective amp concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, (more...) Company: Blue Shield of California Location: Hawaiian Gardens Posted on: 07/15/2025 Behavioral Health Case Management - Nurse, Senior Description: Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive (more...) Company: Blue Shield of California Location: Cypress Posted on: 07/15/2025 Licensed Clinician, Senior Description: Your Role The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination approvals for members using BSC evidenced (more...) Company: Blue Shield of California Location: Seal Beach Posted on: 07/15/2025 Licensed Clinician, Senior (ABA Case Manager) Description: Your Role Reporting to the Manager, Care Management- Behavioral Health, the Licensed Clinician, Senior ABA Case Manager helps members with behavioral health needs navigate the health care system for (more...) Company: Blue Shield of California Location: Cypress Posted on: 07/15/2025 Licensed Clinician, Senior Description: Your Role The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination approvals for members using BSC evidenced (more...) Company: Blue Shield of California Location: Stanton Posted on: 07/15/2025 Behavioral Health Case Management - Nurse, Senior Description: Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive (more...) Company: Blue Shield of California Location: Lakewood Posted on: 07/15/2025 |
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