- Prime Healthcare (Chino, CA)
- …for its quality, including as among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Prime Healthcare (Anaheim, CA)
- …effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case-manager utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityWest Anaheim Medical… more
- Prime Healthcare (San Dimas, CA)
- …effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/case-manager-%28rn%29 utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySan Dimas Community… more
- JBS USA (Manteca, CA)
- …(good or bad) + Plan and schedule corrective work to maximize crew utilization and effectiveness + Review work requests (SAP Notifications), collaborate with ... on the next week's available hours (crew size) in order to build weekly schedule + Review Planned Backlog of work that is ready to execute + Select work from backlog… more
- BrightSpring Health Services (Sacramento, CA)
- …and submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on ... meetings* Chairs committees as applicable (eg safety, infection control, incident/accident review , human rights, etc.).* Participates in the development of the… more
- Liberty Healthcare Corporation (Redwood City, CA)
- …finance, quality assurance and operations teams + Participating in peer review , utilization management, incident reporting, performance improvement, and quality ... assurance initiatives + Scheduling staff to assure optimal staffing levels based on program census and client needs + Championing diversity, equity and inclusion while fostering a mission driven, high performance culture + Supporting the Executive Director in… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... community care regulations, and Veterans Health Administration (VHA) standards and guidelines. The HH RN uses nursing knowledge and systems theory to assess, organize, facilitate, and guide Veterans through their full range of care options including… more
- Ventura County (Ventura, CA)
- …+ Develops and presents therapeutic class review for medical staff review to include utilization , financial analysis, contract compliance, safety and ... policies and procedures or clinical practice guidelines to optimize drug utilization and medication safety while meeting accreditation standards and regulations. The… more
- Centene Corporation (Sacramento, CA)
- …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 California market**...2 years in acute care and managed care, with utilization management experience This is a great opportunity to… more
- Centene Corporation (Sacramento, CA)
- …California RN Licensing Highly Preferred **Position Purpose:** Performs a clinical retrospective review of services previously provided to determine if the level of ... quality, cost efficiency, and are within compliance. + Performs a clinical review of post-care services by reviewing medical records against guidelines and clinical… more