- KBR (San Diego, CA)
- …clients with cutting-edge solutions and services. We are seeking a stellar Special Operations Nurse Case Manager that will provide a full range of professional ... care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual... license; full, active, and unrestricted license as a Registered Nurse in one of any US… 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
- 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
- University of Southern California (Los Angeles, CA)
- …outside hospital transfers, Transfer Center operations, and Care Coordination operations (including Case Management, Social Work, Utilization Review ) for ... preferably in a complex or academic medical center Required Licenses/Certifications: + Req Registered Nurse - RN (CA Board of Registered Nursing) +… 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
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... to a line operation responsible for the delivery of psychological rehabilitation, case management and/or Psychiatric Emergency Service of the Department of Mental… more
- Highmark Health (Sacramento, CA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... **EXPERIENCE** **Required** + 7 years in any combination of clinical, case / utilization management and/or disease/condition management experience, or provider… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... assigned to a line operation responsible for delivering psychological rehabilitation, case management, and/or psychiatric emergency services in the Department of… more
- Elevance Health (Walnut Creek, CA)
- …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... facility-based and outpatient professional treatment health benefits through telephonic or written review . **Primary duties may include but are not limited to** : +… more
- Amergis (Orange, CA)
- … Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more