- Prime Healthcare (Inglewood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse (RN) license is required. 2. Five years acute care nursing… more
- UCLA Health (Los Angeles, CA)
- …with the Cardiology Clinic Operations Manager, you will be accountable for the clinical care and the daily operations of the clinic. Duties include but are ... + Provide leadership and direct supervision, monitoring, and evaluation of the clinical and administrative clinic staff. + Coordination of clinical services… more
- Prime Healthcare (Lynwood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum...of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five… more
- Stanford Health Care (Palo Alto, CA)
- …risk stratification of at-risk patient populations, acute and skilled nursing facility concurrent review and complex and episodic case management, including the ... member homes, provider offices or facility settings. S/he will conduct concurrent review and issue appropriate member/provider correspondence. **Locations**… more
- LA Care Health Plan (Los Angeles, CA)
- …prospective, concurrent , post-service, and retrospective claim medical review processes. Utilizes clinical judgement, independent analysis, critical-thinking ... and processes. Actively participates in the discharge planning process, including providing clinical review and authorization for alternate levels of care, home… more
- Sacramento County (Sacramento, CA)
- …Psychologist, Licensed Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may be cause for ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may… more
- Stanford Health Care (Palo Alto, CA)
- …improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; ... payers to assure reimbursement for patient services/procedures. Communicates with review organizations/payers to provide requested clinical and psychosocial… more
- Sharp HealthCare (San Diego, CA)
- …patient care areas. This position requires the ability to combine clinical /quality considerations with regulatory/financial/utilization review demands to assure ... Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM)… more
- Dignity Health (San Luis Obispo, CA)
- …duties as assigned. **Qualifications** **Education and Experience:** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... initiatives, including but not limited to, activities focused on clinical quality improvement, patient safety and risk reduction, patient...root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). +… more
- Centene Corporation (Sacramento, CA)
- …complete for allergies, height, weight, current and past medical history, clinical laboratory results and concurrent medications (including over-the-counter or ... + Assess responses to therapy, patient compliance, and ongoing review of drug regimens; report and manage adverse events...report and manage adverse events + Assist the physician, nurse and patient with clinical and technical… more