- LA Care Health Plan (Los Angeles, CA)
- …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program… more
- Sutter Health (Modesto, CA)
- …Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE** RN - Registered Nurse of California BLS-Basic Life Support Healthcare ... glad you are interested in joining Sutter Health! **Organization:** MMC-Memorial Medical Center **Position Overview:** The position has the responsibility for… more
- University of Southern California (Los Angeles, CA)
- …consistently and correctly Monitors EEG pattern for signs of seizure activity Notifies RN /Charge Nurse promptly of EKG changes or concerns Never leaves the ... use of computer systems. Prints 2130 census for charge RN , 2400 census for census log Checks accommodation codes...reason for transfer and assures connection is made. + Medical Records Maintenance Assists with the management of patient… more
- University of Southern California (Los Angeles, CA)
- …preferably in a complex or academic medical center Required Licenses/Certifications: + Req Registered Nurse - RN (CA Board of Registered Nursing) ... operations, and Care Coordination operations (including Case Management, Social Work, Utilization Review ) for Keck Medical Center (Keck & Norris Hospitals). The… more
- Sutter Health (San Francisco, CA)
- …Master's in Healthcare (MPH, MHA, MS, MBA, etc.) **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California OR MD- Medical Doctor OR DO-Doctor of ... group of individuals and departments, including members of the medical staff. + Dependable with a demonstrated ability to...Reviews HAC/PSI database content weekly to support CDS account review + Works in tandem to provide clear communication… more
- Public Consulting Group (El Cajon, CA)
- …adult protective services, or the Department of Developmental Disabilities + A Licensed registered nurse ( RN ), a licensed social worker (LSW, LISW), ... as required. + Approves/denies case management prevention plan. + Completes Quality Assurance review of investigations (high profile and random sample) + Serves as a… more
- Highmark Health (Sacramento, CA)
- …+ 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related ... claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of… more
- Dignity Health (Sacramento, CA)
- …mock survey tracers. **Job Requirements** **Education and Experience:** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... reduction, patient experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for...analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). +… more
- Dignity Health (Northridge, CA)
- …around critical quality and safety initiatives. **Job Requirements** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... care setting required. + Must be able to perform case reviews for medical staff peer review and medical and/or surgical Registry Abstraction required. + One… more
- Alameda Health System (Oakland, CA)
- …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + Monitor and evaluate… more