- Prime Healthcare (Ontario, CA)
- …of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of experience ... perform a holistic and comprehensive review of the medical record for the medical necessity, intensity of service and...in utilization review, referrals, authorizations, denials and appeals. + Current… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219588/case- manager %2c-rn utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
- Prime Healthcare (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case- manager -%28rn%29 utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
- Alameda Health System (Oakland, CA)
- …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Utilization Review RN...system. 9. Conduct concurrent and admission reviews of patient records to assess medical necessity and adherence to evidence-based… more
- Sharp HealthCare (San Diego, CA)
- …Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager ... (CCM) - Commission for Case Manager Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA) **Hours** **:** **Shift Start… more
- Alameda Health System (Oakland, CA)
- Clinical Nurse IV - (Assistant Nurse Manager ) - Labor & Delivery - (L&D) + Oakland, CA + Highland General Hospital + Labor and Delivery + Full Time - Night + ... the organizational structure of a unit which promotes effective and economic utilization of personnel and supplies; assures availability and operability of supplies… more
- CVS Health (Sacramento, CA)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... position consists of working intensely as a telephonic case manager with patients and their care team for fully...**Required Qualifications** + 5+ years' experience as a Registered Nurse (RN) with at least 1 year of experience… more
- VNA Health (Santa Barbara, CA)
- …a $5,000 sign on BONUS! Job Description: VNA Health is looking for compassionate Registered Nurse Case Managers (RN CM) to join our Home Health care team. The RN CM ... all aspects of every patient on his/her caseload to include: appropriate utilization of services; ensuring continued skilled need; monitoring of homebound status;… more
- Fresenius Medical Center (Moreno Valley, CA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Therapies Program. + Maintains integrity of medical and operations records and complies with all data collections and auditing… more
- Fresenius Medical Center (San Bernardino, CA)
- …Services departments. Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies Program. * Maintains integrity of ... medical and operations records and complies with all data collections and auditing...of Disease (ICD) coding. *Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more