- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,... in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with… more
- University of Southern California (Arcadia, CA)
- …Minimum of three years' experience in clinical disciplines (RN, MD, FMG) or utilization review /case management in an acute care facility, with clinical ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- Insight Global (Victorville, CA)
- …* Manage and document medical records for off-site referrals * Facilitate weekly Utilization Review Committee meetings * Provide general clerical support * ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
- STG International (Victorville, CA)
- …patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... of Quality Performance Improvement Team (QPIT) strategic initiatives. *Participate in review and improvement of clinical success in of areas of responsibility.… more
- ERP International (Camp Pendleton, CA)
- …patient safety by monitoring and tracking the enrolled population for hospital admissions and emergent/urgent utilization , making contact with the patient, ... manuals, reports and actively engages patients in their health care. + Review details and expectations regarding referrals with patients. + Provide support to… more