- 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
- Children's Hospital Los Angeles (Los Angeles, CA)
- …of healthcare services provided to all admitted patients. Using a value-based approach the Utilization Review Nurse ensures that care is administered via ... Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review including medical… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management ...as needed to assist with patient care coordination and utilization review . The incumbent will be responsible… 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
- Cognizant (Sacramento, CA)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Insight Global (Campbell, CA)
- …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Job Description - Review approximately 60 medical authorization requests per day...- Apply specific health plan guidelines and policies - Review clinical notes and identify key medical criteria -… more
- 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 ... be unrestricted. **Essential Functions** + Referral CoordinationEnsures consistent application of the utilization review process for effective utilization of… more
- Lincoln Financial (Sacramento, CA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… 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