- 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 ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &...Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to… more
- The County of Los Angeles (Los Angeles, CA)
- …goals. + Develops and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in a timely manner. + ... of care and establishes and modifies program monitoring and review methods as necessary. + Oversees audits and the...A valid, current license to practice as a registered nurse issued by the appropriate State of California licensing… more
- Providence (CA)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... and Data Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records… more
- Actalent (Sacramento, CA)
- …(eg, med-surg, telemetry, ICU) + At least 1 year of experience in utilization review , case management, or hospital discharge planning + Familiarity with ... Remote Licensed Vocational Nurse (LVN) Fully remote but MUST reside within...of the Sacramento area Job Duties + Perform timely utilization reviews for Medicare inpatient admissions, continued stays, and… more
- The County of Los Angeles (Los Angeles, CA)
- …goals. Develops and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in a timely manner. ... acceptable standards of care and establishes and modifies program monitoring and review methods as necessary. Oversees audits and the implementation of audit… more
- STG International (Victorville, CA)
- …patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... in the orientation of clinical staff physicians, physician assistants and nurse practitioners. *Provide leadership to CBOC clinicians. *Evaluate the effectiveness of… more
- KBR (San Diego, CA)
- …compliance in meeting care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... the electronic medical records of all patients contacted for review by the managing physician; Routinely staffs difficult cases...and services. We are seeking a stellar Special Operations Nurse Case Manager that will provide a full range… more
- Alameda Health System (San Leandro, CA)
- …specific clinical information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post ... the direction of the Care Management social worker and/or nurse , facilitates, identifies and documents all referrals made to...in a health care field or one year in Utilization Management at a Medical Group or Health plan… 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
- Cedars-Sinai (Los Angeles, CA)
- …to patient evaluation, consultation, and care coordination, supported by three nurse practitioners and specialized staff. + **Theranostics** - the cutting-edge ... performance and quality improvement, risk management, and efficient resource utilization , all linked to evidence-based medicine. They will attract, mentor,… more