- Sutter Health (San Francisco, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and… more
- HCA Healthcare (Los Gatos, CA)
- …us apart from any other healthcare provider. We are seeking a Operating Room Nurse to join our healthcare family. **Benefits** Los Gatos Surgical, offers a total ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …store-and-forward) palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to ... necessity and urgency. Refers complex cases to the CCRNs for more in-depth review . Analyzes submitted medical documentation to ensure all components necessary to… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. + Maintains knowledge of developmental tasks and ... and substance abuse conditions. POSITION TITLE: Assessment & Referral Registered Nurse PAY RANGE: $63.00-$78.00 per hour REPORTS TO: Director of Assessment… more
- Cedars-Sinai (Los Angeles, CA)
- …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint ... through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to support the level of service rendered to… more
- Elevance Health (Costa Mesa, CA)
- **Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
- VNA Health (Santa Barbara, CA)
- … of services; ensuring continued skilled need; monitoring of homebound status; review of documentation in the medical record; maintenance of interdisciplinary ... Job Description: VNA Health is looking for compassionate Registered Nurse Case Managers (RN CM) to join our Home...directs home care services. Responsibilities: + Responsible for continuous review of all aspects of every patient on his/her… more
- Molina Healthcare (San Diego, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will ... requests within required timelines. + Refers appropriate cases to Medical Directors and presents them in a consistent and...in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours** **:** ... in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... provides information to the department head as indicated. + Utilization review and utilization managementThe...communicates this to the care team.Refer defined cases for medical secondary review and share findings with… more