- LA Care Health Plan (Los Angeles, CA)
- …direct patient care that may include at least 2 years of relevant Licensed Vocational Nurse (LVN) experience in a UM or CM capacity substituted for 1 year of ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical...nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get… more
- Centene Corporation (Sacramento, CA)
- …Remote position. Must work PST **RN-Must hold a current CA license.** **Must have** ** 2 -4 years related** **experience in UM -Concurrent Review. 2 + years of ... 2 - 4 years of related experience. 2 + years of acute care experience required. Clinical...management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + For Health Net… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Bachelor's Degree in Nursing Experience Required: Minimum of 7 years of acute/ clinical care experience. Minimum of 2 years of experience in ... Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA,...nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management and… more
- LA Care Health Plan (Los Angeles, CA)
- …for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, ... Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more
- Sharp HealthCare (San Diego, CA)
- …Time** Bachelor's Degree in Nursing; Bachelor's Degree; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Professional in ... improvement as a representative of SCMG. Provides support to the VP for Clinical Operations and HS leadership team to ensure regulatory and legislative compliance… more
- Molina Healthcare (San Diego, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will ... Monday thru Friday 8:30AM to 5:30PM PACIFIC throughout a 2 - 3 month training and then will move...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more