- The County of Los Angeles (Los Angeles, CA)
- …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility of children referred… more
- Humana (Sacramento, CA)
- …new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... and help us put health first** The UM Administration Coordinator contributes to administration of utilization management....the nursing team + Builds and pends authorizations for review + Responsible for inbound and outbound calls to… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… more
- Prime Healthcare (Inglewood, CA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+ year of… more
- Prime Healthcare (Ontario, CA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred.2. Utilization Review experience is highly preferred.3. Clinical experience in acute… more
- Dignity Health (Bakersfield, CA)
- …in the quarterly business review to integrate drug procurement and drug utilization . The coordinator will "take call" as necessary to address emergent ... **Job Summary and Responsibilities** The Clinical Pharmacy Coordinator is responsible for coordinating the clinical programs and decentralized provision of… 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 ... innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Bakersfield, 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
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