- Elevance Health (Walnut Creek, CA)
- …and providers. **How you will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive ... care. + Perform physician-level case review, following initial nurse review, of chemotherapy regimens....and other staff in understanding the principles behind appropriate utilization of covered treatments and genetic testing. + Participate… more
- Dignity Health (Oxnard, 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
- University of Southern California (Arcadia, CA)
- ESSENTIAL JOB FUNCTIONS AND CORE RESPONSIBILITIES * Accountable to the unit Manager and/or the Director of the department.* Adherence to identified nursing standards ... all professional and patient care interactions.* Performs other duties as assigned by Manager / Director / Clinical Lead RN.* Prioritizes cases to provide service to… more
- Actalent (Sacramento, CA)
- …+ Working knowledge of EZ-CAP, EZ-Net, InterQual, and MCG preferred. + Certified Case Manager (CCM), CPUR, or CPHM credential preferred. + Background in ... med-surg, telemetry, ICU) + At least 1 year of experience in utilization review, case management, or hospital discharge planning + Familiarity with CMS inpatient… more
- Dignity Health (Merced, CA)
- …related healthcare field + At least five (5) years of nursing experience + Certified Case Manager (CCM), + Accredited Case Management (ACM-RN), or UM ... with multiple stakeholders + Professional communication skills + Understand how utilization management and case management programs integrate. + Ability… more
- KBR (San Diego, CA)
- …with cutting-edge solutions and services. We are seeking a stellar Special Operations Nurse Case Manager that will provide a full range of professional health ... care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential...years nursing experience and must be certified as a case manager by a recognized certifying organization,… more
- Ventura County (Ventura, CA)
- …guidelines, as well as Post Stabilization notifications; + Acts as a liaison and case manager between the inpatient facility and referral agencies; + Refers ... ideal candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of experience in… more
- LA Care Health Plan (Los Angeles, CA)
- …Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager ... clinical skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating… 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 (ALD) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017...dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all… more
- Genesis Healthcare (Elk Grove, CA)
- …clinical management of the rehabilitation department, including oversight related to case management, quality improvement, care planning, clinical utilization , ... of therapy staff. 7. Assists in daily staffing and utilization in cooperation with input from treating therapists, consideration...utilize the numerous resources available to me as a manager and an employee. take pride in my work… more
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