- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This ... clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and… more
- Cedars-Sinai (Los Angeles, CA)
- …one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management ( UM ) Registered Nurse - Medicare Short Stay & Concurrent Denials ... in accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity,...Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse -Utilization Review Case Manager -… more
- ERP International (Twentynine Palms, CA)
- **Overview** ERP International is seeking ** Registered Nurse ( RN ) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more
- Cedars-Sinai (CA)
- …why US News & World Report has named us one of America's Best Hospitals. As a Registered Nurse , Care Coordinator at Cedars-Sinai you will; + You will serve as a ... Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management preferred or...continued employment. **Req ID** : 14082 **Working Title** : Registered Nurse - Care Coordinator - 8… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... + For patients who are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF's for continued review and… more
- Cedars-Sinai (CA)
- …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 12784 **Working Title** : Registered Nurse - Care Coordinator - 8 Hour Days **Department** : Case ... **Education:** + BSN required **License/Certification:** + Current, unrestricted California RN license + American Heart Association BLS + Case Management… more
- Elevance Health (Cerritos, CA)
- **Behavioral Health Care Manager II, UM ** **Location:** California **Virtual:** This role enables associates to work virtually full-time, with the exception of ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...equivalent background. + Current active unrestricted license such as RN LCSW LMHC LPC LMFT or Clinical Psychologist to… more
- CenterWell (Sacramento, CA)
- …**Use your skills to make an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN ) with no disciplinary action and ... caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking… more
- LA Care Health Plan (Los Angeles, CA)
- …for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted California ... Utilization Management Nurse Specialist RN II Job Category:...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... the status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning needs and documents is computer system… more