- Providence (Mission Hills, CA)
- …field (Acute, Ambulatory, or Post-Acute). + 2 years experience in Acute Care Management (Care Coordination or Utilization Management ) or successful ... **Description** Care Management in Hospital/Health Care Systems is a collaborative...achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient's right to… more
- Dignity Health (Oxnard, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing , physicians, ancillary departments, insurers ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Sharecare (Sacramento, CA)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Stanford Health Care (Palo Alto, CA)
- …trends within health care and academic medical centers that may impact product/service utilization or Value Based Management processes. + Collaborate with key ... analytics is essential for data-driven decision-making, along with proven project management skills to track and oversee initiatives from inception to completion.… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …The Licensed Vocational Nurse plays a vital role within the Case Management Department. The LVN within the Utilization Management team collaborates ... education necessary to meet licensure requirements. One year experience in Utilization Review or Case Management discharge planning, current knowledge/use… more
- Providence (Tarzana, CA)
- … management of the patient along the continuum of care, utilization activities, disease management appropriateness, discharge planning, patient education ... Degree Healthcare related field. + Upon hire: California Registered Nurse License + Management experience in a hospital/health care environment. + 3 years… more
- UCLA Health (Los Angeles, CA)
- … staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + Minimum of three years ... and find out for yourself. Using your advanced practice nursing skills, you will be responsible for assessing and...quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and… more
- Elevance Health (Los Angeles, CA)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures, chairs and schedules meetings, as ... **Telephonic Nurse Case Manager Sr** **Sign on Bonus: $5000.**... Case Manager Sr** . is responsible for care management within the scope of licensure for members with… more
- Elevance Health (Los Angeles, CA)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.**...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- CommonSpirit Health (Rancho Cordova, CA)
- …leading up to or including supervisory role highly preferred + Experience in Utilization Management , Case Management or Care Coordination, Managed Care ... communication with others, including but not limited to: hospital administration, nursing leadership or their designee, medical staff, physicians and transportation… more