Top 42 Documentation & utilization review Jobs in Eureka, Ca

UM Genetic Counselor Medical Reviewer
Wollborg Michelson Recruiting —California
- $62.00 - $64.70 an hour
- Full-time
- LVN
- Windows
- Master's degree
- Health insurance
- Dental insurance
Quick Apply
7d
Registered Nurse Case Manager
Medcadre Inc —Eureka, CA
- $65 - $70 an hour
- Email
- Acute care
- RN License
- Hospital
- Health insurance
- 401(k)
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9d
APEX Program Manager
NorCal APEX Accelerator —Arcata, CA
- $92,000 - $115,000 a year
- Weekends as needed
- Background check
- Customer service
- 5 years
- Paid holidays
- Health insurance
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9d
Nurse Practitioner/Physician Assistant
FOWAD Advanced Nursing Services Inc —California
- $85 - $150 an hour
- Per diem
- Vital signs
- Mid-level
- Outpatient experience
- Flexible schedule
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8d
Transportation Supervisor
Humboldt Senior Resource Center —Arcata, CA
- $24.85 - $27.97 an hour
- Full-time
- CDL B
- Background check
- CPR Certification
RN Discharge Planner - CalAIM
Wellpath —Eureka, CA
- $64.13 - $71.25 an hour
- 8 hour shift
- Nursing
- RN License
- Mid-level
- Wellness program
- Health savings account
7d
RN Discharge Planner - Juvenile
Wellpath —Eureka, CA
- Part-time
- Nursing
- RN License
- Mid-level
- Wellness program
- Health savings account
13d
Behavioral Health Nurse I/II
Humboldt County —Eureka, CA
- $40.57 - $52.06 an hour
- 12 hour shift
- Background check
- Nursing
- RN License
- Commuter assistance
- Paid holidays
Occupational Therapist
Granada Rehabilitation & Wellness Center —Eureka, CA
- $58 - $63 an hour
- Full-time
- CPR Certification
- Management
- Customer service
Quick Apply
2d
Supervising Behavioral Health Nurse
Humboldt County —Eureka, CA
- $47.12 - $60.46 an hour
- 12 hour shift
- Background check
- CPR Certification
- Nursing
- Commuter assistance
- Paid holidays
Speech Language Pathologist
Providence at Home with Compassus —Eureka, CA
- $46.57 - $72.29 an hour
- Part-time
- CPR Certification
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
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Speech-Language Pathologist
Seaview Rehabilitation & Wellness Center —Eureka, CA
- $60 - $65 an hour
- Full-time
- CPR Certification
- Management
- Customer service
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1d
Nursing Director
Humboldt IPA —Eureka, CA
- $60.00 - $78.18 an hour
- Full-time
- Acute care
- Nursing
- RN License
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Physical Therapist
Fortuna Rehabilitation & Wellness Center —Fortuna, CA
- $58 - $63 an hour
- Full-time
- CPR Certification
- Management
- Doctoral degree
Quick Apply
13d
Occupational Therapist
Fortuna Rehabilitation & Wellness Center —Fortuna, CA
- $58 - $63 an hour
- Full-time
- CPR Certification
- Management
- Customer service
Quick Apply
2d
Energy Storage - Design Phase Manager, Preconstruction
M. A. Mortenson Company —United States
- $110,700 - $166,100 a year
- Full-time
- Hybrid work
- Construction site
- Customer service
- Bachelor's degree
- AD&D insurance
- Paid holidays

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Registered Nurse Case Manager
Medcadre Inc —Eureka, CA
Collaborate with physicians, nursing staff, social services, and interdisciplinary teams. Qualified candidates will be contacted promptly for next steps.
$65 - $70 an hour
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9d
Nurse Case Manager I
Partnership HealthPlan of California —Eureka, CA
California driver’s license and proof of current automobile insurance. Telephone and computer data entry skills required. Quality and cost-effective outcomes.
$106,667.05 - $138,667.16 a year
11h

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 Respond to emails and telephone calls punctually and complete tasks as directed.  Ability to engage in active listening (giving full attention to those…
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documentation & utilization review jobs near eureka, ca

UM Genetic Counselor Medical Reviewer

Wollborg Michelson Recruiting -
California

Quick Apply

Job Details

Full-time | Contract
$62.00 - $64.70 an hour
7 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Certified Genetic Counselor (CGC)
Windows
Master's degree
Clinical case management
Genetic counseling
Utilization management
Ad-hoc reporting

Full Job Description

Genetic Counselor
Job Summary

Provides clinical genetic counseling and supports utilization management activities involving genetic testing, medical necessity review, prior authorization, concurrent review, and post-service review.

Responsibilities

Evaluate genetic testing requests using clinical guidelines, medical policies, and medical necessity criteria.
Perform prior authorization, concurrent review, and post-service review activities.
Apply utilization management principles and applicable regulatory and accreditation standards.
Support the development and interpretation of genetic testing medical policies.
Document clinical decisions and communicate recommendations in a managed care or clinical environment.

Requirements

Master’s degree in Genetic Counseling from an accredited program.
Current certification as a Genetic Counselor or equivalent national certification.
Active, unrestricted genetic counselor licensure.
At least five years of relevant experience in genetic counseling, molecular medicine, genetic testing, carrier screening, prenatal testing, newborn testing, or neonatal intensive care.
At least three years of case management experience.
At least two years of experience as a registered nurse or licensed vocational nurse, with strong clinical judgment.
Experience with prior authorization, concurrent review, and post-service review preferred.
Experience in a health plan, administrative services, or independent practice association setting preferred.

Summary Qualification

Strong clinical understanding of molecular, cellular, and genetic medicine.
Knowledge of somatic and germline genetic testing and related clinical applications.
Working knowledge of utilization management, medical necessity review, regulatory requirements, and accreditation standards.
Strong analytical, clinical decision-making, and documentation skills.

Skill

Genetic counseling and clinical assessment.
Utilization management and case management.
Medical policy interpretation and development.
Prior authorization, concurrent review, and post-service review.
Strong computer skills with Windows-based applications.
Experience with Topaz and IBM FileNet preferred.

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one’s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one’s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.

Pay: $62.00 - $64.70 per hour

Benefits:

Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: Remote

Quick Apply

Refine Your Search

documentation & utilization review jobs in eureka, ca

UM Genetic Counselor Medical Reviewer

Registered Nurse Case Manager

APEX Program Manager

Nurse Practitioner/Physician Assistant

Transportation Supervisor

RN Discharge Planner - CalAIM

RN Discharge Planner - Juvenile

Behavioral Health Nurse I/II

Occupational Therapist

Supervising Behavioral Health Nurse

Speech Language Pathologist

Speech-Language Pathologist

Nursing Director

Physical Therapist

Occupational Therapist

Energy Storage - Design Phase Manager, Preconstruction

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