- Humana (Sacramento, CA)
- …service or customer service telephone experience desired. + Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care ... of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …education necessary to meet licensure requirements. One year experience in Utilization Review or Case Management discharge planning, current knowledge/use ... vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case Managers, support staff, insurance… 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
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