- UCLA Health (Los Angeles, CA)
- …the philosophy and objectives set forth by the Director of Transplant Services, the Nurse Manager for the solid organ transplant program is accountable for the ... QA/PI program. Additional responsibilities include assessing and monitoring medical case management protocols to maintain effective long-term patient management,… more
- Sacramento County (Sacramento, CA)
- Supervising Public Health Nurse Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/600083) Apply Supervising Public Health Nurse Salary ... Nurses work under general administrative supervision of a higher-level health program manager , and receive medical direction as needed from a physician or… more
- Elevance Health (Costa Mesa, CA)
- …+ Provides caller with appropriate community resources as necessary. + Refers more complex issues as needed for consultation. ** Nurse Demand Management II:** + ... ** Nurse Demand Management** **Sign On Bonus:$3,000** Carelon Health...resources. + Assists lower level and refers only more complex issues as needed for consultation. + May assist… more
- Alameda Health System (Oakland, CA)
- Nurse , Care Management + Oakland, CA + Highland General Hospital + HGH Care Coordination + Full Time - Day + Care Management + $77.67 to $113.98 per hour + Req ... McKesson Interqual(R) clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination. + Takes appropriate action when… more
- UCLA Health (Los Angeles, CA)
- …or MSN degree, required + Current unrestricted California RN license, required + Certified Case Manager (CCM) preferred + Three or more years of clinical nursing ... for our Medicare Advantage members. As a Care Management Nurse , you will focus on improving health outcomes and...outcomes and streamlining the care journey for members with complex healthcare needs. In this position, you will work… more
- Travelers Insurance Company (Irvine, CA)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. +… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to ... EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather...there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare, Medicaid, and/or… more
- ICW Group (Pleasanton, CA)
- …and receives support from dedicated in-house counsel for litigation strategy and nurse case managers for medical management. **ESSENTIAL DUTIES AND ... of MCU claims examiners to build judgment and capabilities to effective manager complex and catastrophic cases from early intervention to mitigate exposure to… more
- Dignity Health (San Luis Obispo, CA)
- …**Job Summary:** The primary function of the Quality/Patient Safety Program Manager is to support, coordinate, and facilitate the quality management (QM), ... patient experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review, OPPE, FPPE). + Participates in an integral… more
- Sutter Health (Modesto, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... to the Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to avoid unnecessary admissions.… more