- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)...in Case Management , CCM. + Experience with Utilization Management and/or Quality Assurance in a… 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
- Cedars-Sinai (CA)
- …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... Doing** The Case Manager 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
- ERP International (Twentynine Palms, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking **Registered Nurse (RN) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine Palms, CA**… more
- Actalent (Sacramento, CA)
- …(eg, med-surg, telemetry, ICU) . At least 1 year of experience in utilization review, case management , or hospital discharge planning . Familiarity with ... LVN- Hybrid Job Duties: . Perform timely utilization reviews for Medicare inpatient admissions, continued stays,.... Conduct in-person hospital rounds 2-3 days per week, telephonic review and participate in interdisciplinary case reviews .… 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 (Marina Del Rey, CA)
- …established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... Employee Referral Bonus **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from pre-hospitalization through… more
- University of Southern California (Los Angeles, CA)
- …of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management , discharge ... status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning...years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the… more
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