- Centene Corporation (Sacramento, CA)
- …benefits including a fresh perspective on workplace flexibility. Job Description **Concurrent Review Nurse - Remote (California Market | Health Net)** **Centene ... is seeking a** **Remote Concurrent Review Nurse ** **to support our** **Health Net...2 years in acute care and managed care, with utilization management experience** **Position Purpose:** Performs concurrent… more
- Providence (Torrance, CA)
- …Care Honor Roll by the California Surgeon General for 2024.The The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient ... Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review ,...Associate's Degree - Nursing degree/diploma upon hire. + California Registered Nurse License upon hire. + 2… more
- VNA Health (Santa Barbara, CA)
- …in clinical education, inservice and nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary ... Schedule: 3 days/week, 12 hours/day Job Description: The Inpatient Registered Nurse provides hospice care and is...and families in the General Inpatient setting. The Inpatient RN fully supports the Core Values and is accountable… 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
- Fresenius Medical Center (Bellflower, CA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… 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 ... TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of...continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program… more
- CommonSpirit Health (Rancho Cordova, CA)
- …responsibilities leading up to or including supervisory role + Experience in Utilization Management , Case Management or Care Coordination, Managed ... **Job Summary and Responsibilities** **ICU RN , Emergency Room RN or Level...with department manager and director the outcomes of the review and any identified issues or barriers. **Core Duties:**… more
- 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
- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Cedars-Sinai (Beverly Hills, CA)
- …care assessments, and a variety of medically related tasks. The Supervisor is a registered nurse who works in an administrative role in an ambulatory care ... You Will be Doing The Supervisor of Clinical Operations RN supports the physician and clinical staff in the...as a liaison, for administrative support activities including facilities management , pharmacy, utilization management , quality… more