- Dignity Health (Glendale, 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 (Long Beach, 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
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Dignity Health (Oxnard, 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 (Rancho Cordova, CA)
- …of Conditions of Participation and Joint Commission standards. **Preferred Qualifications:** - Accredited Case Manager , Case Management Nurse, and/or ... operations including , but not limited to: clinical resource management , discharge planning activities, patient advocacy, clinical social work...Qualifications:** - 3+ years in a Care Coordination or Case Manager role. - Associates of Nursing… more
- Dignity Health (Merced, CA)
- …effectively with multiple stakeholders + Professional communication skills + Understand how utilization management and case management programs ... + At least five (5) years of nursing experience + Certified Case Manager (CCM), + Accredited Case Management (ACM-RN), or UM Certification preferred… more
- KBR (San Diego, CA)
- …provider, behavioral health consultant and/or psychiatry consultant; and Performs case management functions. Required Education/Experience/Skills/Training: + Po ... services. We are seeking a stellar Special Operations Nurse Case Manager that will provide a full... by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing… more
- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... Post Stabilization notifications; + Acts as a liaison and case manager between the inpatient facility and...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
- Actalent (Sacramento, CA)
- …experience (eg, med-surg, telemetry, ICU) + At least 1 year of experience in utilization review, case management , or hospital discharge planning + ... of the Sacramento area Job Duties + Perform timely utilization reviews for Medicare inpatient admissions, continued stays, and...of EZ-CAP, EZ-Net, InterQual, and MCG preferred. + Certified Case Manager (CCM), CPUR, or CPHM credential… more
- Sharecare (Sacramento, CA)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include… more