- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Dignity Health (San Bernardino, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Sutter Health (Oakland, CA)
- …Review , oversight of workflow and Materials Programs related to cost savings, utilization and case carts. MAINTAINS AND ENSURES COMPLIANCE OF NATIONAL, SYSTEM ... ABSMC-Ashby Campus **Position Overview:** At the direction of the Manager , Distribution & O/R Materials Manager and...methods to improve workflow and increase job efficiency of staff.( case cart) + Acts as a resource to personnel.… more
- Elevance Health (Walnut Creek, CA)
- …of 4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of ... granted as required by law._** The **Medical Management Nurse** is responsible for review of the most complex or challenging cases that require nursing judgment,… more
- The County of Los Angeles (Los Angeles, CA)
- …eligibility determination, appeals investigation, quality auditing, fraud investigation, or GAIN case management. OPTION 2: Four years of experience in a responsible ... will need a copy of your DD214 form to review , so please include that with your application or...making recommendations to line managers on matters such as: utilization of personnel, allocation of funds, workload and workload… more
- Sharp HealthCare (San Diego, CA)
- …for admission to rehab, including patients not admitted, for reporting purposes, utilization review , marketing, and rehab administration and in compliance with ... discrepancies or errors are identified, recommend changes as needed to internal case manager /staff.Ensures that documentation relative to IRF-PAI is maintained… more
- LA Care Health Plan (Los Angeles, CA)
- …II collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting ... Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more
- Elevance Health (CA)
- …or equivalent. Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or skill of a… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... exercises supervisory authorities and responsibilities involving work assignment and review , as well as administrative and personnel management functions relative… more