- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Evolent (Sacramento, CA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management … more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/211752/ utilization - review - rn ... of nursing and a current state Registered Nurse license. + Minimum 3 years RN ...Plan. + At least 3 years of experience in utilization review , referrals, authorizations, denials and appeals.… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219588/case-manager%2c- rn utilization - ... Text: ### Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
- The County of Los Angeles (Los Angeles, CA)
- …squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... Nurse ? In the County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management experience whose primary charge is to ensure… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Proficient in application of clinical guidelines ... **Responsibilities** Responsible for the review of medical records for appropriate admission status...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Prime Healthcare (San Dimas, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan… more
- HCA Healthcare (Riverside, CA)
- …a balance of optimal care and appropriate resource utilization . Requirements: + Registered Nurse ( RN ) with current California license required, Case ... Hospital! **Job Summary and Qualifications** The Coordinator of Case Management ( RN CM) is responsible for promoting...Management Certification or utilization review preferred + Associate's Degree minimum… more
- HCA Healthcare (Riverside, CA)
- …a balance of optimal care and appropriate resource utilization . Requirements: + Registered Nurse ( RN ) with current California license required, Case ... be an evening shift position. The Coordinator of Case Management ( RN CM) is responsible for promoting...Management Certification or utilization review preferred + Associate's Degree minimum… more