- Dignity Health (Bakersfield, CA)
- …of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for ... physician review based on medical necessity. The position...to coordinate patient care. - Promotes quality, cost effective medical care through strict adherence to all utilization… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Stanford Health Care (Palo Alto, CA)
- …patient care and pioneering cross-disciplinary research that translates the latest medical advancements into clinical practice. As part of Stanford University School ... of Medicine, one of the world's leading medical centers, we are committed to shaping the future...a surgical specialty as a Physician Assistant (PA) or Nurse Practitioner (NP), with a preference for at least… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Dignity Health (Bakersfield, CA)
- …of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for ... the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity...physician review based on medical necessity. The position… more
- Alameda Health System (Oakland, CA)
- …contracted vendors. + Responsible for the coordination and support of the AHS Utilization Review Committee. + Responsible for overseeing patient, physician and ... manages the collection, analysis and presentation data relevant to the utilization of healthcare resources, including but not limited to avoidable/variance days,… more
- Rising Medical Solutions (Los Angeles, CA)
- … medical case management, occupational health, orthopedics, home health care, utilization review , or quality assurance + Familiarity with regional physicians ... Career with Rising Medical Solutions Are you an experienced workers' compensation nurse case manager eager to bring your expertise to a team that's passionate… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …Learn more Duties and responsibilities of the LVN/LPN include: Performs retrospective medical review of non-VA health care records to determine ... Summary The Intermittent Licensed Vocational Nurse /Practical Nurse (LVN/LPN) has a broad...Refers complex cases to the CCRNs for more in-depth review . Analyzes submitted medical documentation to ensure… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
- Amergis (French Camp, CA)
- …40 hours per week RNs will be doing denials, discharge planning, and utilization review Hiring points for a perfect candidate: Current Discharge Planning ... ensuring optimumutilization of resources, service delivery, and compliance with medical regime. Minimum Requirements: + Current RN licensure in...experience Utilization review InterQual experience Working with multidisciplinary… more