- Sharp HealthCare (San Diego, CA)
- …by our recruitment and hiring teams. **What You Will Do** To provide comprehensive utilization management and coordination of care for SRS Members. Ensure timely ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing...in a hospital or clinical setting. + 2 Years utilization /Case Management experience, preferably in a Managed… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying… more
- Sharp HealthCare (La Mesa, CA)
- …Qualifications** + 3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse (RN) - CA Board of Registered ... competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as… more
- Alameda Health System (Oakland, CA)
- … Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The ... Nurse , Care Management + Oakland, CA +...background. Within the last 3 years, experience in Case Management in an acute setting or utilization review… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: The expected pay… more
- UCLA Health (Los Angeles, CA)
- …of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management ... the delivery of program functionalities in all aspects of Utilization Management and its integration with other...We're seeking an experienced leader with: + A Registered Nurse License, Advanced Practice Provider ( Nurse Practitioner… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Additional experience in clinical nursing . + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: *In ... used to fill a vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used to fill other vacancies… more
- Actalent (Santa Barbara, CA)
- …working within one of several Health Services' operational units. These units include Utilization Management , Case Management , Enhanced Care Management , ... HPNC may perform a range of activities such as utilization management , case or disease management...nursing standards of practice. Essential Skills + Registered Nurse with strong clinical knowledge of adult or pediatric… more
- Molina Healthcare (San Bernardino, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Sharp HealthCare (San Diego, CA)
- …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... policy.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more