- Ventura County (Ventura, CA)
- …expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities such as ... Description Are you a licensed Psychiatric Technician or Vocational Nurse in California looking to make a real difference...other members of the mental health team. + Case Management : + provides case management /brokerage including linkage… more
- Stanford Health Care (Palo Alto, CA)
- …least 3 years in a surgical specialty as a Physician Assistant (PA) or Nurse Practitioner (NP), with a preference for at least 1 year in Plastic/Reconstructive ... is a Stanford Health Care job.** **A Brief Overview** Provides supervision and management of advanced practice providers (APPs) in a distinct clinical service line.… more
- Rising Medical Solutions (Los Angeles, CA)
- …medical case management , occupational health, orthopedics, home health care, utilization review , or quality assurance + Familiarity with regional physicians ... Your Career with Rising Medical Solutions Are you an experienced workers' compensation nurse case manager eager to bring your expertise to a team that's passionate… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the ... medical necessity. The position partners with both the Pre-Service and In-Patient Utilization Management teams. Ensures to monitor and assure the appropriateness… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …demonstrating a high level of administrative and leadership responsibility and utilization of management skills including conflict resolution. Ability to ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities The RN - Clinical Program Supervisor… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
- Sutter Health (Modesto, CA)
- …case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... management , quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers… more
- Sedgwick (Sacramento, CA)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- Select Medical (Los Angeles, CA)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more