- 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 ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...general and specialized principles, practices, techniques and methods of utilization review / management , discharge planning or… more
- Centene Corporation (San Diego, CA)
- …abuse addiction disorders experience is required. + Direct experience with Utilization Review or Utilization Management related to Behavioral Health case ... or Remote - TX** **Position Purpose:** Performs a clinical review and assesses care related to mental health and...experience is preferred + Experience in Behavioral Health Case Management or Utilization Management in… more
- Dignity Health (Rancho Cordova, CA)
- … Utilization Review (UR) LVN uses clinical judgement in providing utilization management (UM )services. The focus is to provide high quality, ... outcomes of patients. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. - 5 years LVN experience. -… more
- CenterWell (Sacramento, CA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Centene Corporation (Sacramento, CA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Providence (Anaheim, CA)
- …+ Upon hire: California Registered Nurse License + 3 years Experience in utilization management and/or case management . + 3 years Clinical experience in ... **Description** Responsible for providing utilization review and coordination of care...or related field. + Upon hire: Certification in Case Management (CCM) **Why Join Providence?** Our best-in-class benefits are… more