- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens… more
- Elevance Health (Walnut Creek, CA)
- ** Utilization Management Representative I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative I** is responsible for...and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible… more
- Prime Healthcare (Chino, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/219949/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top...community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Prime Healthcare (San Dimas, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Centene Corporation (Sacramento, CA)
- …offering competitive benefits including a fresh perspective on workplace flexibility. **Concurrent Review Nurse - Remote (California Market | Health Net)** ... Centene is seeking a **Remote Concurrent Review Nurse ** to support our **Health Net...2 years in acute care and managed care, with utilization management experience This is a great… more
- Centene Corporation (Sacramento, CA)
- …Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health ... care issues, and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare providers,… more
- Humana (Sacramento, CA)
- …leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million Medicare ... members. The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a ** Nurse Practitioner** for a full-time position supporting the **Pain Management Clinic** at **Camp Pendleton, ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Sharecare (Sacramento, CA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more