- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333)...needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review… more
- UCLA Health (Los Angeles, CA)
- …for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role...protocols and national clinical guidelines (eg, InterQual, Milliman) in review decisions. + Coordinates escalations to medical … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Cedars-Sinai (Los Angeles, CA)
- …necessity reviews with accepted criteria required **Req ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour ... the nation by US News & World Report. Cedars-Sinai Medical Center is an organization known nationally for excellence...will you be doing in this role?** The Utilization Review Case Manager validates the patient's placement to be… more
- Cedars-Sinai (Los Angeles, CA)
- …Motions, Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse -Utilization Review Case Manager - 8 Hour Days **Department** ... Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent Denials supports post-discharge clinical… more
- Ventura County (Ventura, CA)
- …patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and ... Senior Medical Management Nurse - VCHCP Print...are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and… more
- UCLA Health (Los Angeles, CA)
- …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan ... Description The Quality Management Nurse is responsible for conducting comprehensive facility site...and safety. In this role, you will supports all Medical Group Health Education & Disease Management Programs utilizing… more
- Ventura County (Ventura, CA)
- Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per Diem Print ... (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4935075) Apply Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/utilization- review - nurse -lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Required qualifications: + Possess an active CA Licensed Vocational Nurse (LVN) license. + Minimum (2) two years of...limited to, paid time off, a 401K retirement plan, medical , dental, and vision coverage, tuition reimbursement, and many… more
- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,...medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review … more