- HCA Healthcare (Riverside, CA)
- … (RN) with current California license required, Case Management Certification or utilization review preferred + Associate's Degree minimum required + Bachelor's ... career path, we encourage you to apply for our Coord Case Mgmt opening. We review all applications. Qualified candidates will be contacted by a member of our team.We… more
- Sutter Health (Tracy, CA)
- …Reports EOC activities, opportunities, and needs to leadership. * Serves as Nurse Educator, providing ongoing education and orientation to clinical staff. Assists ... of decisions implemented on any shift. Documents shift events for administrative review . * In the absence of individual managers, serves as functional authority… more
- Magellan Health Services (San Diego, CA)
- …care plan, member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity ... care support teams. Experience with Care Management flows. Knowledge of utilization management procedures, mental health and substance abuse community resources and… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... co-workers and hospital staff. The duties of this position vary widely requiring utilization of different processes and methods to accomplish this work. The work… 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
- Dignity Health (San Andreas, CA)
- …provided; participate in annual review of patient health records and utilization review studies of the Clinic services. + Maintain confidentiality of ... and minister medical treatments and medication; collaborate/supervise with the nurse practitioner/physician assistant in order to plan and coordinate patient… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... Certification (Advanced Cardiac Life Support) - American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing; AHA Basic Life Support… more
- HCA Healthcare (Thousand Oaks, CA)
- …today!** **Job Summary and Qualifications** The Clinical Nursing Manager is a registered nurse who reports directly to the unit Director or Chief Nursing Officer. ... and accountable for monitoring the delivery of patient care through the utilization of the nursing process, physicians' orders, established policies and procedures,… more
- Dignity Health (Carmichael, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... **Responsibilities** ** Nurse Manager of Care Coordination / Case Management**...Case Management** **Sign On / Relocation Options** As our ** Nurse Manager Care Coordination Manager at Mercy San Juan… more
- Sharp HealthCare (La Mesa, CA)
- …correct billing codes and modifiers as appropriate.Demonstrate competency in utilization of computer applications including RIS, PACS, voice recognition, ... prescription).* Accurately associate the patient to their images and ordered procedure. Review the reason for the procedure and appropriateness of exam.* Escalate… more