- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/229421/case- manager -%28rn%29 utilization - ... or management , preferred. + Current BCLS certificate preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Montclair… more
- LA Care Health Plan (Los Angeles, CA)
- … Knowledge of state, federal and regulatory requirements in Care/Case/ Utilization Management . Strong verbal and written communication skills. Computer ... Supervisor, Utilization Management RN Job Category: Clinical...Care's culturally diverse membership. The position supports the UM Manager /Director. This role also assists UM Educator/ Manager /Director… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or CM. Knowledge of Department of Health ... Utilization Management Admissions Liaison RN II...current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case Management Association (ACM)… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/rn-case- manager utilization ... year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS (AHA) certificate, preferred.5. Knowledge of Milliman… more
- Sharp HealthCare (San Diego, CA)
- …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- Prime Healthcare (San Dimas, CA)
- …to stakeholders. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications. 1. Knowledge in discharge planning/ utilization management /case ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/234279/discharge-planner-ii-%28lvn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan… more
- Prime Healthcare (Montclair, CA)
- …Discharge Plan. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/221097/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMontclair… more
- Elevance Health (Los Angeles, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for...medical or insurance field preferred. + Behavioral Health related knowledge is preferred. + For URAC accredited areas, the… more
- Dignity Health (Sacramento, CA)
- …in the role:** + Understand how utilization management and case management programs integrate + Knowledge of CMS standards and requirements + Highly ... **Job Summary and Responsibilities** The ** Utilization Review RN** is responsible for the review...+ Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification ** Knowledge to… more
- Providence (Mission Hills, CA)
- …health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, ... and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse...UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree - Nursing. +… more