- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive… more
- UCLA Health (Los Angeles, CA)
- …patient records. + Working knowledge of laws, rules, and regulations regarding utilization review and discharge planning functions of government programs such ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This… more
- Ventura County (Ventura, CA)
- …+ Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At ... with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + Direct patient… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... nursing experience or case management experience. + 3 Years case management, utilization review , care coordination experience. + California Registered Nurse (RN)… more
- Molina Healthcare (CA)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review - Review prospectively, concurrently and retrospectively, all… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... Management and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct initial … more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... medical record and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM I will:Conduct initial … more
- Ventura County (Ventura, CA)
- …general direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ... Duties may include but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and… more