Top 9 Utilization review nurse Jobs in Bakersfield Ca

Clinical Review Specialist (Bakersfield)
Adventist Health —Bakersfield, CA
- $81,273 - $121,909 a year
- Day shift
- Nursing
- RN License
- Mid-level
11d
UM Nurse Reviewer, LVN - Bakersfield 1.2
Universal Healthcare MSO LLC —Bakersfield, CA
- $31.00 - $54.18 an hour
- Full-time
- Nursing
- LVN
- RN License
- Health insurance
- Dental insurance
Lead Nurse | Intake (Mon-Fri)
Bakersfield Behavioral Healthcare Hospital —Bakersfield, CA
- $91,520 - $127,670 a year
- Full-time
- Acute care
- CPR Certification
- RN License
- Disability insurance
- Health insurance
Quick Apply
RN Night Shift (PRN, Intake)
Bakersfield Behavioral Healthcare Hospital —Bakersfield, CA
- $91,520 - $127,670 a year
- 12 hour shift
- Acute care
- CPR Certification
- RN License
- Disability insurance
- Health insurance
Quick Apply
Utilization Review Specialist LVN
Bakersfield Behavioral Healthcare Hospital —Bakersfield, CA
- $56,305 - $69,201 a year
- Full-time
- Acute care
- LVN
- Adults
- Disability insurance
- Health insurance
Quick Apply

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Utilization Management (UM) LVN Case Manager
CENTRIC HEALTHCARE SERVICES —Bakersfield, CA
Strong customer service skills with good telephone rapport. Validate data entry process for errors. Data entry for additional requested services, as needed.
$30 - $34 an hour
Quick Apply
RN Case Manager - $2650/weekly gross
NETPACE Health —California
Collaborate with physicians, nursing staff, social services, and interdisciplinary teams to develop and implement patient care plans.
$2,650 a week
Quick Apply
6h

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Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the…
$70,726 - $148,921 a year
4d
Utilization Review Specialist
Lighthouse Behavioral Health Solutions —Columbus, OH
Bachelor's degree in behavioral health, nursing, social work, or a related field required. Working knowledge of CPT and ICD-10 coding systems, with relevant…
Quick Apply

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Clinical Review Specialist (Bakersfield)

Adventist Health -
Bakersfield, CA

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Job Details

$81,273 - $121,909 a year
11 days ago

Qualifications

CPHQ
Data integrity assurance
Medical performance measurement report preparation
Nursing
Certified Professional In Patient Safety
RN License
Healthcare Administration
CMS
Hospital quality control
Metrics Reporting
Mid-level
Associate's degree in healthcare administration
Patient safety
Data summary reports
Quality reports
Quality control data reporting
Data quality management
Clinical feedback sessions
CMS regulatory compliance
Clinical performance metrics
Health information data integrity
Clinical program data analysis
Associate's degree in health information management
Health record chart audits
Medical record abstraction
Continuous clinical improvement initiatives
Vendor communication
Vendor quality assurance
Health information management
Health Information Management

Full Job Description

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Responsible for the collection, abstraction, validation, and submission of clinical data to support CMS quality programs, patient safety measures, national clinical registries and/or peer review data. Ensures the accuracy and integrity of reported data, supports compliance with regulatory requirements, and contributes to performance improvement initiatives. Applies clinical knowledge to identify trends, monitor quality outcomes, and provide actionable feedback to leaders and clinicians. Supports confidentiality of peer review activities, prepares trended reports for leadership and medical staff committees, and assists in maintaining compliance with accreditation and regulatory standard. Is essential to achieving internal and external quality and patient safety targets.

Job Requirements:

Education and Work Experience:

Associate's or Technical Degree in Nursing, Healthcare Administration, or Health Information Management or equivalent combination of education and experience: Required
Two years' of experience in quality management, data abstraction, or healthcare analytics: Required
Three years' of experience in peer review, abstraction, quality assurance, or hospital data reporting: Preferred

Licenses/Certifications:

Registered Nurse (RN) license or equivalent health background: Preferred
Certified Professional in Healthcare Quality (CPHQ) or CPPS: Required

Essential Functions:

Performs concurrent and retrospective chart abstraction for peer review, quality, and regulatory reporting using defined criteria. Ensures data accuracy and timeliness of submissions to internal and external databases.
Performs case abstraction for assigned registries and/ or CMS IOR and QOR measures (e.g., STS, CoC, NSQIP, or other specialty registries). Collaborates with outsourced registry vendors and maintain effective communication with system quality teams. Ensures timely data submission to meet internal and external reporting requirements.
Serves as a liaison between the Quality Department, clinical stakeholders, and registry partners. Provides feedback to physicians, nurses, and leaders on documentation gaps or trends impacting data accuracy. Supports initiatives to improve compliance with quality metrics.
Adheres to all confidentiality requirements under state and federal peer review protections. Ensures that data collection and storage comply with Evidence Code §1157, PSWP, and organizational policies.
Monitors data trends to identify opportunities for clinical process improvement. Provides reports and data insights to Quality and Patient Safety leaders. Supports performance improvement teams with accurate, validated data to guide interventions.
Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

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Refine Your Search

utilization review nurse jobs in bakersfield ca

Clinical Review Specialist (Bakersfield)

UM Nurse Reviewer, LVN - Bakersfield 1.2

Lead Nurse | Intake (Mon-Fri)

RN Night Shift (PRN, Intake)

Utilization Review Specialist LVN

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