- LA Care Health Plan (Los Angeles, CA)
- …of staff . Ensure team effectiveness and project completion. Duties Review and process complex and/or escalated clinical A&G cases. Analyze the patient ... clinical unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for...tracking of case status. Leads the work of assigned staff ; regularly assigns and checks the work of others,… more
- University of Southern California (Los Angeles, CA)
- …Qualifications: + Pref Bachelor's degree + Pref 1 year Case management or utilization review experience within the last three years preferred. Required ... populations. The RN case manager role integrates the functions of utilization management, quality management, discharge planning assessment, and coordination of… more
- Insight Global (Los Angeles, CA)
- Job Description Insight Global is seeking a skilled Registered Nurse Supervisor for a community health/wellness clinic in Southern Los Angeles. The position ... will manage on average 5 employees between MA's, LVN's, RNs and administrative staff . 75% of responsibilities are geared toward staff administration (scheduling,… more
- Sharp HealthCare (Chula Vista, CA)
- …License and all California State and Federal regulatory requirements. Assist staff with providing care to patients who have been administered radiopharmaceuticals ... correct billing codes and modifiers as appropriate.Demonstrate competency in utilization of computer applications including RIS, PACS, voice recognition,… more
- City and County of San Francisco (San Francisco, CA)
- …Manage the nursing department to maintain quality standards of care, and advise medical staff , department heads, and NHA in matters related to nursing service 5. ... Review daily work assignments to ensure they meet regulatory...rehabilitative and restorative activities, instruction in self-help aids, and utilization of available therapeutic services (PT, OT, ST), promotes… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... primary care team including pharmacists, social workers, dieticians, behavioral health staff , to provide a robust interdisciplinary approach to care. Evaluating… more
- LA Care Health Plan (Los Angeles, CA)
- …risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff , Health Homes ... Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse (RN);current and unrestricted California License OR Licensed Clinical… more
- Sutter Health (San Francisco, CA)
- …market to support overall program performance metrics. Responsible for new staff onboarding, periodic employee reviews including annual evaluations, and leave ... Effectively communicates initiatives to executives, operational leaders, and front-line staff . **Job Description** : **EDUCATION:** + Bachelor's: Nursing + Master's… 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 ... each individual in the classification. 1. Physically assess each resident and interviews staff as necessary to ensure good standard of practice and as instructed in… more
- Cedars-Sinai (CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the...work in a growing community focused hospital where every staff member feels like family. **Req ID** : 11088… more