- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... THE POSITION: Under direction of a physician or registered nurse , the Field Based Psychiatric Technician performs a variety...such as utilization review , monitoring and evaluation procedures, and… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …degree preferred. + Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. + Per Diem Positions: Case ... and hospital information systems required. Must demonstrate knowledge of current utilization management principles, third party payor review requirements,… more
- Hospice Of San Joaquin (Stockton, CA)
- …about the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... utilization of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration. + Incorporates… more
- Stanford Health Care (Palo Alto, CA)
- …various problem-solving techniques to deal with technical queries. + Demonstrated ability to review utilization reports and data. + Ability to identify trends ... stratification of at-risk patient populations, acute and skilled nursing facility concurrent review and complex and episodic case management, including the care plan… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours** **:** ... in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning… more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... Description Are you a licensed Psychiatric Technician or Vocational Nurse in California looking to make a real difference...such as utilization review , monitoring and evaluation procedures, and… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse ... of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Stanford Health Care (Palo Alto, CA)
- …least 3 years in a surgical specialty as a Physician Assistant (PA) or Nurse Practitioner (NP), with a preference for at least 1 year in Plastic/Reconstructive ... development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS),...and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond… more