- UCLA Health (Los Angeles, CA)
- …or MSN Degree + CA RN + Preferably minimum of 2 years' experience in utilization management , Inpatient CM or clinical Experience in Oncology department. + Must ... complex care coordination for high-risk MA cancer patients. The Nurse Case Manager uses the nursing process...aims to foster continuity of care and reduce unnecessary utilization of healthcare services by coordinating and providing health… more
- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... CANDIDATE The ideal candidate is an experienced Mental Health Nurse with a background in utilization review...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
- Sutter Health (Roseville, CA)
- …Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted ... and at the appropriate level of care. Coordinates the utilization management , resource management , discharge...accredited school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN-Registered Nurse… more
- 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. ... and CMS criteria required + A minimum of three years of experience in utilization management , preferred + Team leading or management experience, preferred… more
- Sutter Health (Emeryville, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop...of care such as Home Health, Hospice, Advance Illness Management (AIM), and Palliative Care. Skilled Nursing … more
- Sutter Health (Modesto, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop...of care such as Home Health, Hospice, Advance Illness Management (AIM), and Palliative Care. Skilled Nursing … more
- Actalent (Santa Barbara, CA)
- …Registered Nurse assigned to various Health Services operational units, including Utilization Management , Case Management , Enhanced Care Management , ... Child Model, and Population Health programs. The role involves performing utilization management activities, care coordination, or population health activities… more
- Sharp HealthCare (San Diego, CA)
- …skills in area of expertise. + Proficient knowledge and understanding of utilization management , case management , healthcare finances, alternative care ... (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing...clinical experience in area of specialty. + 2 Years Utilization /Case Management experience, preferably in a Managed… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience in the acute ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- Molina Healthcare (San Francisco, CA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... statistics including plan utilization , staff productivity, cost-effective utilization of services, management of targeted member...experience. * At least 1 year of health care management leadership experience. * Registered Nurse (RN).… more