- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an… more
- Sharp HealthCare (La Mesa, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...services are directed to appropriate network providers, and obtains prior authorization for in network and out… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...services are directed to appropriate network providers, and obtains prior authorization for in network and out… more
- Medtronic (Stockton, CA)
- …more of the following fields: + Certified Diabetes Care and Education Specialist (CDCES) + Registered Nurse ( RN ) + Registered Dietitian (RD) + Physician ... compassionate world. **A Day in the Life** Medtronic is seeking a Clinical Territory Manager (CTM) to support the education and training of the company's products to… more
- Molina Healthcare (Long Beach, CA)
- …skills. * Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Registered Nurse ( RN ). License must be active and ... Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager ...be a good fit for this position. Strong UM Prior Authorization experience highly preferred. Further details… more
- Molina Healthcare (Los Angeles, CA)
- …skills. * Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Registered Nurse ( RN ). License must be active and ... JOB DESCRIPTION **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement...least 2 years of experience with the following: UM, Prior Authorization , NCQA accreditation, and knowledge of… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...Psychiatrists in completing and checking for accuracy on Treatment Authorization Request (TAR) and Prior Authorization… more
- Amergis (Orange, CA)
- Amergis Healthcare is seeking a highly motivated an experienced LMFT/LCSW Medical Case Manager to help support a health insurance agency! The Medical Case Manager ... Management) will be responsible for reviewing and processing requests for authorization and notification of behavioral health services from health professionals,… more
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