- Elevance Health (Costa Mesa, CA)
- ** Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care management… more
- Sharecare (Sacramento, CA)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the… more
- LA Care Health Plan (Los Angeles, CA)
- …such as ambulatory care, home care, palliative care, hospice care OR experience in Utilization Review or Care Management will be considered in lieu of direct ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department:...and/or disabilities in a UM/CM environment. Preferred: Experience in utilization review , skilled nursing, home health, discharge… more
- CVS Health (Sacramento, CA)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Stanford Health Care (Palo Alto, CA)
- …various problem-solving techniques to deal with technical queries. + Demonstrated ability to review utilization reports and data. + Ability to identify trends ... Care **What you will do** + Inpatient & SNF Utilization Management & Care Coordination: + Support proactive hospital...+ Reduce avoidable inpatient and SNF bed days through telephonic & in person concurrent review , proactive… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Cedars-Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review ... 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