- CenterWell (Sacramento, CA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... unrestricted RN license with the ability to obtain Compact Nursing License + A minimum of three years clinical...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- Sharp HealthCare (San Diego, CA)
- …; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing ; Certified Case Manager (CCM) - Commission for Case Manager ... 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 (Lynwood, CA)
- …care nursing experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred.4. Current BCLS ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn-case- manager utilization… more
- Sharp HealthCare (San Diego, CA)
- …**FTE** 1 **Shift Start Time** **Shift End Time** Other; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians ... Nurse (LVN) program. + California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing...health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers.… more
- Providence (Mission Hills, CA)
- …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...must empower them. **Required Qualifications:** + Associate's Degree in Nursing . + California Registered Nurse License upon… more
- Elevance Health (Walnut Creek, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... to 5:05 PM Pacific. Training hours may vary. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- University of Southern California (Los Angeles, CA)
- …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... Specialized/technical training Graduate of an accredited school of registered nursing + Req 3 years Clinical experience. + Req...+ Pref Bachelor's degree + Pref 1 year Case management or utilization review experience within the… more
- University of Southern California (Los Angeles, CA)
- The Nurse Manager holds 24-hour accountability for the quality of patient care, efficiency of operations, and human resources management for area(s) ... experience in a cost-effective manner, while applying evidenced-based leadership and practice. The Nurse Manager is responsible for the provision of safe patient… more
- University of Southern California (Los Angeles, CA)
- The Nurse Manager holds 24-hour accountability for the quality of patient care, efficiency of operations, and human resources management for area(s) ... experience in a cost-effective manner, while applying evidenced-based leadership and practice. The Nurse Manager is responsible for the provision of safe patient… more