- Elevance Health (Los Angeles, CA)
- ** Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care … more
- ICW Group (Sacramento, CA)
- …of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and Field Nurse ... + Acts as a gatekeeper for referrals between in-house telephonic nurse case managers, claims examiners and... management issues related to bill review, case management and utilization review. + Works closely… more
- Sharecare (Sacramento, CA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...for supporting the goals and objectives of the Disease Management program by providing high quality telephonic … more
- Actalent (Santa Barbara, CA)
- …efficiently to support member care plan goals. + Perform utilization management activities, which may include telephonic or onsite clinical review; case ... Remote Utilization Management RN Leading healthcare facility...Remote Utilization Management RN Leading healthcare facility that aims to...need is now looking for a REMOTE Health Plan Nurse Coordinator to join their team! Here you will… more
- CVS Health (Sacramento, CA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... aggregate progress and individual ECM member cases. May use telephonic , onsite, or written methods and both group and... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more
- Cedars-Sinai (CA)
- …established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from pre-hospitalization… more
- Cedars-Sinai (Beverly Hills, CA)
- …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon discharge from...of care. Use evidence based review guidelines to conduct utilization review as is appropriate to match the payor… more
- Dignity Health (Rancho Cordova, CA)
- …responsible for providing telephonic clinical assessment, health education and utilization management services to a variety of patients. **Job Requirements** ... triage nurse experience + Familiarity with an electronic practice management system **Where You'll Work** Dignity Health Medical Foundation, established in 1993,… more