- Dignity Health (Los Angeles, CA)
- …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Dignity Health (Long Beach, CA)
- …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Dignity Health (Glendale, CA)
- …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Dignity Health (Long Beach, CA)
- …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Evolent (Sacramento, CA)
- …Responsible for coordinating education and findings with matrixed Physician Business Manager . + Provides medical direction to the support services review process. ... Responsible for the quality of utilization review determinations, including appeals. + Provides input into...as needed for new hires and completes new hire case assessment working on any defined areas of opportunity.… more
- Sutter Health (Oakland, CA)
- …Product Review, oversight of workflow and Materials Programs related to cost savings, utilization and case carts. MAINTAINS AND ENSURES COMPLIANCE OF NATIONAL, ... ABSMC-Ashby Campus **Position Overview:** At the direction of the Manager , Distribution & O/R Materials Manager and...methods to improve workflow and increase job efficiency of staff.( case cart) + Acts as a resource to personnel.… more
- The County of Los Angeles (Los Angeles, CA)
- …eligibility determination, appeals investigation, quality auditing, fraud investigation, or GAIN case management. OPTION 2: Four years of experience in a responsible ... analysis and making recommendations to line managers on matters such as: utilization of personnel, allocation of funds, workload and workload fluctuations, and… more
- Elevance Health (Walnut Creek, CA)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review, or case management experience; or any combination of education ... thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment,… more
- Elevance Health (Sacramento, CA)
- …Coordinator - RN Clinician** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN ... clinicians participating in the member's case in accordance with applicable state law and contract;...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- LA Care Health Plan (Los Angeles, CA)
- …II collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting ... Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more