- LA Care Health Plan (Los Angeles, CA)
- …Preferred Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse - Board Certified (CMGT-BC) ... acuities or care needs and requiring the highest clinical skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care… more
- Gilead Sciences, Inc. (Foster City, CA)
- …utilization . + Demonstrated practical and technical experience in business case development, planning, implementation, operation, and management of digital ... problems + Demonstrated excellence in delivering skilled communications around change management that build system adherence + Demonstrated excellence in building… more
- Elevance Health (Los Angeles, CA)
- …critical thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate ... about plan benefits and physicians and may assist with case management . + Collaborates with leadership in...Med/Surg, Critical Care, ER, Telemetry, etc. strongly preferred. + Utilization management /review within managed care or hospital… more
- Molina Healthcare (San Bernardino, CA)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Bachelor's Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management , or Quality Management ... Management program that includes initial and concurrent review; case management /discharge planning activities. Responsible for operational...direction of the manager of in-patient care management and the Director of Utilization … more
- Providence (Torrance, CA)
- …may considered (in lieu of acute care). + 2 years Experience as a case manager in an acute care setting. **Preferred Qualifications:** + Bachelor's Degree ... **Description** **Appeals RN - Care Manager Remote. This position is Per Diem and...in Nursing. Or Master's Degree Nursing. + Upon hire: Case management certification. + Experience working with… more
- Highmark Health (Sacramento, CA)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned ... and federal law standards and are within the care manager 's professional discipline. + For assigned case ...**Required** + 7 years in any combination of clinical, case / utilization management and/or disease/condition … more
- Edwards Lifesciences (San Francisco, CA)
- …**How you will make an impact:** + Working independently in the areas of valve crimping, case management , pre- case planning, post- case management , 3 ... educational material during training sessions in order to drive utilization of the Edwards's THV product portfolio. + Utilizing...+ Working independently in the areas of valve crimping, case management , pre- case planning, post-… more
- Dignity Health (Los Angeles, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Dignity Health (Bakersfield, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers...least five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case … more