- UCLA Health (Los Angeles, CA)
- …and family. Ability to represent the Medical Center in site visits and review by managed care, insurance groups, and regulatory entities. + Ability to provide ... ability to work independently and prioritize workload. Ability to manage numerous concurrent tasks in a high stress environment and deal with change. Preferred:… more
- Dignity Health (Rancho Cordova, CA)
- …This position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may include: - ... within the Greater Sacramento, CA region.** **Position Summary:** The Utilization Review (UR) LVN uses clinical judgement in providing utilization management (UM… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Experience working in a remote UR environment… more
- LA Care Health Plan (Los Angeles, CA)
- …not limited to, placement (with level of care) criteria (MCG, InterQual), concurrent review , and discharge planning. Preferred: Consistent Critical Care ... physical therapy, infusion), and case management referrals (5%) Performs prospective, concurrent , post-service, and retrospective claim medical review processes.… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
- Sacramento County (Sacramento, CA)
- …of California to practice as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The word "experience" referenced in the ... applications have been improperly rejected may request the Employment Services Division to review its decision to reject the application. If the applicant desires to… more
- Sacramento County (Sacramento, CA)
- …Licensed Clinical Social Worker, Marriage and Family Therapist, or Registered Nurse . AND Either: Two years of experience coordinating and/or supervising mental ... Two years of experience in the class of Mental Health Counselor, Psychiatric Nurse , Senior Mental Health Counselor, Senior Psychiatric Nurse , or Supervising… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing; ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more
- Sharp HealthCare (La Mesa, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more
- Sharp HealthCare (La Mesa, CA)
- …real and potential quality issues through measurement and analysis along with concurrent and retrospective review of performance information. Assists with ... Healthcare Quality (CPHQ) - National Association for Healthcare Quality; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Professional in… more