- Ventura County (Ventura, CA)
- …and patient care as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments. + ... Engages in ongoing education and training to stay current with best practices in emergency nursing care. + Performs other related duties as required. Typical Qualifications These are entrance requirements to the exam process and assure neither continuance in… more
- Sedgwick (Rancho Cordova, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred.… more
- WestCare Foundation (Fresno, CA)
- …meetings and presentations with referral agencies. + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the program. ... + Assist in the development of program fiscal and budgetary tracking systems and implementation as well as providing the oversight and management of operating budget and program fiscal expenditures. + Monitor compliance with all required standards,… more
- Stanford Health Care (Palo Alto, CA)
- …+ ICU/ED and Academic Medical Center experience preferred. + Case management, utilization review and/or direct provider interaction experience, preferred. + ... Experience in public speaking, as well as educational content creation and delivery of formal multidisciplinary education, preferred. + Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred. **Required… more
- Sedgwick (Orange, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred.… more
- Sharp HealthCare (San Diego, CA)
- …response to therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan ... as necessary. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age,… more
- Dignity Health (Carmichael, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... patient care. + Consults and collaborates with other managers, physicians, administration, and community based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literatur \#LI-DH \#CCMSJMC… more
- Dignity Health (Woodland, CA)
- …closely with the RN Care Coordinator to coordinate care plans based on the utilization review activities performed by the RN Care Coordinator with compliance of ... federal state and third party payers. The Social Worker will be required to participate in performance improvement initiatives related to appropriate patient care management and perform other departmental duties as assigned. The care team program improves the… more
- Rising Medical Solutions (Los Angeles, CA)
- …nursing, medical case management, occupational health, orthopedics, home health care, utilization review , or quality assurance + Familiarity with regional ... physicians + CCM, and COHN-S/CM are optional but highly valued + Ability to drive to appointments within a 2-hour radius + Active, unencumbered registered nursing license with a minimum of 5 years' experience Benefits + Opportunity to make a difference in… more
- WestCare Foundation (Fresno, CA)
- …staff development, education and training activities; + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the program; ... + Assist in the development of program fiscal and budgetary tracking systems and implementation as well as providing the oversight and management of operating budget and program fiscal expenditures; + Monitor compliance with all required standards,… more