- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...an acute hospital setting. At least 2 years of Utilization Management/ Case Management experience in a hospital… more
- University of Southern California (Arcadia, CA)
- …and maintain BLS certification. Preferred (Not required) Professional certification as a case manager preferred. Pay Transparency The hourly rate range for ... the compilation of physician profile data regarding LOS, resource utilization , denied days, cost, case mix index,...regarding LOS, resource utilization , denied days, cost, case mix index, patient satisfaction, and quality indicators. +… more
- Providence (Irvine, CA)
- …working in a remote UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree Nursing. + Master's Degree ... **Description** **RN Utilization Review at Irvine, CA. This position is...Remote 8-hour, Day shifts.** Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical… more
- Providence (Mission Hills, CA)
- …working in a remote UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree in Nursing. + Master's ... **Description** **RN Utilization Review - Remote. This position will work...a 8-hr Day shift.** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews… more
- Prime Healthcare (Montclair, CA)
- …the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. ... EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions,… more
- University of Southern California (Los Angeles, CA)
- In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an ... patient populations. The role integrates the functions of complex case management, utilization management, quality management, discharge...care. As more complex medical treatment options emerge the Case Manager will look to eliminate gaps… more
- Sharp HealthCare (San Diego, CA)
- …American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... employer business practices. **What You Will Do** The Clinical Case Manager 's (CCM) role is to be...community service data for at high risk persons for under- utilization of oncology health services. + Implements Plan of… more
- Sharp HealthCare (San Diego, CA)
- …acute patient care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience ... per departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as… more
- ERP International (Twentynine Palms, CA)
- …of the following certifications: (Must obtain within 18 months of employment.) o Commission for Case Manager Certification Certified Case Manager (CCM) o ... and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case ...Rehabilitation Counselor (CRC) o American Nurses Credentialing Center Nurse Case Manager (RN-NCM) o National Academy of… more
- Sutter Health (San Francisco, CA)
- …nursing **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by entity and time to ... Center Davies **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria for… more