- University of Southern California (Los Angeles, CA)
- … review experience within the last three years preferred. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic Life Support ... The RN case manager role integrates the functions of utilization management, quality management, discharge planning assessment, and coordination of post-hospital… more
- Dignity Health (Rancho Cordova, CA)
- …or Case Manager role. - Associates of Nursing degree. - Clear and current CA Registered Nurse ( RN ) license. - Comprehensive knowledge of care management and ... efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality… more
- Cedars-Sinai (Marina Del Rey, CA)
- …us one of America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from ... the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for… more
- Cedars-Sinai (Los Angeles, CA)
- …approved by the California Board of Registered + Current State of California Registered Nurse and Nurse Practitioner License + National Certification as ... plans to track outcomes for patients in value-based programs, including utilization , cost, efficiency, and appropriateness metrics, as well as clinical outcomes.… more
- Battelle Memorial Institute (San Diego, CA)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… 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 ... Clearance, or the ability to obtain a clearance. * Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State,… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...the department head as indicated. + Utilization review and utilization managementThe RN … more
- Sutter Health (Sacramento, CA)
- …Health Care Administration, or clinical related field **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California **TYPICAL EXPERIENCE:** + 8 ... Responsible for validating and redesigning work flow and clinical content review for all clinical areas. Develops and maintains interdisciplinary teams to… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …an accredited school of professional nursing. Must maintain current license as a Registered Nurse , Master's degree preferred. + Minimum of 3 years' experience ... knowledge and skills in areas of risk management, infection control, and utilization review . + Current knowledge of continuous quality improvement methodology.… more
- Elevance Health (Los Angeles, CA)
- …(Sat & Sun 8am-12pm CST, with a comp day during the week) The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network and appropriateness ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… more