- CommonSpirit Health (Rancho Cordova, CA)
- …leading up to or including supervisory role highly preferred + Experience in Utilization Management , Case Management or Care Coordination, Managed Care ... **Job Summary and Responsibilities** **I** **CU** ** RN , Emergency Room RN or Level...with department manager and director the outcomes of the review and any identified issues or barriers. **Accountabilities:** +… more
- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... License and BLS certification + Recent experience in case management , utilization management and discharge...Knowledge of a large university teaching hospitals Preferred: Strong Utilization Review experience and understanding of CMS… more
- HCA Healthcare (Thousand Oaks, CA)
- …If you find this opportunity compelling, we encourage you to apply for our RN Surgical First Assist opening. We promptly review all applications. Highly ... each individual is recognized. Submit your application for the opportunity below: RN Surgical First AssistLos Robles Regional Medical Center **Benefits** Los Robles… more
- University of Southern California (Arcadia, CA)
- …Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review /case management in an acute care facility, with clinical ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- University of Southern California (Glendale, CA)
- …PRO regulations, JCAHO standards and contractual agreements with insurers or outside review agencies. Minimum Education: Current RN license in the State ... of California, BSN preferred Minimum Experience/Knowledge: Recent experience in Utilization /Quality/Case Management in acute setting preferred Required… more
- Ventura County (Ventura, CA)
- …candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of experience ... evaluation, and review ; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with guidelines and standards… more
- Ventura County (Ventura, CA)
- …CANDIDATE The ideal candidate is a compassionate, adaptable, and clinically skilled registered nurse who excels in delivering comprehensive care to patients ... consistently demonstrating empathy and effective collaboration. PAYROLL TITLES AND APPROXIMATE SALARIES: Registered Nurse II: $52.07 - $62.27 hourly Per Diem … more
- STG International (Victorville, CA)
- …in quality improvement, care management , risk management , peer review , utilization review , clinical outcomes, and health enhancement activates. ... Quality Performance Improvement Team (QPIT) strategic initiatives. *Participate in review and improvement of clinical success in of areas...of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and… more