- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/ rn -case-manager utilization - ... and service! 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
- Highmark Health (Sacramento, CA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Stanford Health Care (Palo Alto, CA)
- …system, analytics and metric management . **Licenses and Certifications** + California Registered Nurse ( RN ) license + American Heart Association Basic ... Overview** The Oncology Research Nursing Professional (ORNP) -is a Registered Nurse ( RN ) who works...directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization … more
- UCLA Health (Los Angeles, CA)
- …The Home Health ICM Coordinator plays a key role in supporting our Utilization Management team to ensure safe, high-quality, and cost-effective care for ... patients enrolled in UCLA Medicare Advantage and Intensive Case Management programs. Under the supervision of the RN Assistant Director, you will coordinate… 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
- Elevance Health (Los Angeles, CA)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses...LPC LBA (as allowed by applicable state laws) LMFT RN or Clinical Psychologist to practice as a health… more
- Elevance Health (Costa Mesa, CA)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Sign on Bonus: $5000.**...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Stanford Health Care (Palo Alto, CA)
- …experience. + ICU/ED and Academic Medical Center experience preferred. + Case management , utilization review and/or direct provider interaction experience, ... Health Care **What you will do** + Responsibility for management and optimization of the positive relationships between CDI...Document Spec . + CCDS-O or CDIP . + Nursing\ RN - Registered Nurse -… more
- Cedars-Sinai (CA)
- …us one of America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from ... timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic ...like family. **Req ID** : 10481 **Working Title** : RN Case Manager - Case Management (ED)… more