- Stanford Health Care (Palo Alto, CA)
- …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or ... competency and adherence to policy through practice analysis and case review of APPs with physicians. +...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse… more
- The County of Los Angeles (Los Angeles, CA)
- …mental health team. Option III : A valid, current license to practice as a registered nurse issued by the appropriate State of California licensing agency -AND- ... and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in...have a valid, current license to practice as a registered nurse issued by the appropriate State… more
- Actalent (Santa Barbara, CA)
- …+ Very collaborative, supportive and helpful team + Fully remote!! REQUIREMENTS: + California Registered Nurse ( RN ) and/or Nurse Practitioner (NP) ... working as soon as possible! Description: + REMOTE + RN with experience in providing Case Management...management activities, which may include telephonic or onsite clinical review ; case or disease management, care coordination… more
- Centene Corporation (Sacramento, CA)
- …competitive benefits including a fresh perspective on workplace flexibility. **California RN license Required** **Schedule M-F 8-5PM PST** **Does not require CA ... National Committee for Quality Assurance (NCQA) standards. + Prepares case reviews for Medical Directors by researching the appeal,...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- Alameda Health System (Oakland, CA)
- …contracted vendors. + Responsible for the coordination and support of the AHS Utilization Review Committee. + Responsible for overseeing patient, physician and ... is required. + Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or valid license as… more
- Ventura County (Ventura, CA)
- …every stage of their journey. THE POSITION: Under direction of a physician or registered nurse , the Field Based Psychiatric Technician performs a variety of ... practice as a licensed Psychiatric Technician or Licensed Vocational Nurse (LVN) in the state of California. This is...and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in… more
- LA Care Health Plan (Los Angeles, CA)
- …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health… more
- Sharecare (Sacramento, CA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Cedars-Sinai (Los Angeles, CA)
- …approved by the California Board of Registered + Current State of California Registered Nurse and Nurse Practitioner License + National Certification as ... daily rounding and interfaces with clinical attendings, nursing staff, pharmacy staff, and case managers (or oversight of same). Patient evaluation and care may be… more
- Alameda Health System (Alameda, CA)
- …and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited ... plans as required by OBRA and PPS. 3. Assists Case Manager with the transfer of patients to other...assessments. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
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