- Stanford Health Care (Palo Alto, CA)
- …job.** **A Brief Overview** The Oncology Research Nursing Professional (ORNP) -is a Registered Nurse ( RN ) who works collaboratively with Clinical Research ... site visits and study close-outs; and collaborates on the review of documentation during protocol audits. + Develops protocol...analytics and metric management. **Licenses and Certifications** + California Registered Nurse ( RN ) license +… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… more
- Trinity Health (Fresno, CA)
- …through the effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse ( RN ) in the state of California is required. 2. ... **Employment Type:** Part time **Shift:** **Description:** This position coordinates utilization review service for defined patient populations across the acute… more
- University of Southern California (Los Angeles, CA)
- … review experience within the last three years preferred. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic Life Support ... The RN case manager role integrates the functions of utilization management, quality management, discharge planning assessment, and coordination of post-hospital… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals &...clinical unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning needs and documents...experience + Req 2 years Ambulatory case management or utilization review experience within the last three… more
- Cedars-Sinai (Marina Del Rey, 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 ... the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... a sign-on bonus not to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning… more
- Dignity Health (Oxnard, CA)
- …AHA BLS card **Skills** + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more