- Providence (Irvine, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** ** RN Utilization Review at Irvine, CA....Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience… more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** ** RN Utilization Review - Remote. This...**Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role...2-3 years of clinical experience in prior authorization, case management , or utilization management + ... We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective...Identify care coordination needs and refer cases to case management as appropriate Qualifications + Active CA RN… more
- TEKsystems (Los Angeles, CA)
- …for a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) with hands-on experience in Utilization Management (UM) and a strong understanding ... Location: West Hills/Canoga Park 91305 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is... license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Ventura County (Ventura, CA)
- …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983) Apply Senior Medical Management … more
- Sutter Health (San Francisco, CA)
- …+ Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case Manager ... Center Davies **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted… more
- Select Medical (San Diego, CA)
- …Friday 8-5pm** **$10,000 Sign On Bonus** **Salary: $135-155,000** **_Clinical license as a registered nurse or respiratory therapist or master's in social work ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …focus includes coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients. Case Managers perform ... in Nursing 4 years nursing in an acute hospital or 2 years Case Management , Utilization Review, or Discharge Planning experience in an acute hospital PREFERRED… more