- LA Care Health Plan (Los Angeles, CA)
- …adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert ... Payment Integrity Nurse Coder RN III Job Category: Clinical Department:...inpatient, outpatient, and professional claims. Serves cross functionally with Utilization Management , Medical Directors, and other internal… more
- The County of Los Angeles (Los Angeles, CA)
- …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... an individual's ability to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience,… more
- Cedars-Sinai (CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the… more
- Stanford Health Care (Palo Alto, CA)
- …of the CVICU team, the APP will play a vital role in the management of post-operative cardiac surgery patients, providing high-quality care in a fast-paced and ... providers in a cutting-edge clinical setting. Key Responsibilities: Patient Care Management : Provide comprehensive care to 4-6 post-cardiac surgery patients per… more
- The County of Los Angeles (Los Angeles, CA)
- …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... Administration + Nursing Education + Health Science + Healthcare Management + Healthcare Education + Healthcare Administration + Public...to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your… more
- Sutter Health (San Francisco, CA)
- …Med Center Davies **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- The County of Los Angeles (Los Angeles, CA)
- …an individual's ability to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience, ... NURSE PRACTITIONER- PEDIATRIC HUB CLINICS/NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2588395) Apply NURSE PRACTITIONER-… more
- CVS Health (Sacramento, CA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …current mental health status. Participates in the FPPE and bi-annual OPPE peer review processes as requested by service. Serves as a preceptor for graduate ... nurse practitioner students. Impact Unit Section Chief Duties: Plans,...goals and objectives. Works with subordinates to ensure optimal utilization of research and training resources and, if appropriate,… more
- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... Mental Health Nurse - Hospital Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4964847) Apply Mental Health Nurse - Hospital Salary… more
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