- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- Sharp HealthCare (La Mesa, CA)
- …Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality; California Registered Nurse ( RN ) - CA Board of Registered ... outcomes including responsibilities relating to leading teams in the utilization of Change Acceleration Process and PI tools and...Board for Professionals in Patient Safety -PREFERRED + California Registered Nurse ( RN ) - CA… more
- Sharp HealthCare (San Diego, CA)
- …BBS Licensed Marriage and Family Therapist (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... BLS Healthcare) - American Heart Association -REQUIRED + California Registered Nurse ( RN ) - CA...in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time… more
- The County of Los Angeles (Los Angeles, CA)
- …mental health team. Option III : A valid, current license to practice as a registered nurse issued by the appropriate State of California licensing agency -AND- ... and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in...have a valid, current license to practice as a registered nurse issued by the appropriate State… more
- Deloitte (Los Angeles, CA)
- …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
- Datavant (Sacramento, CA)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Highmark Health (Sacramento, CA)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- STG International (Victorville, CA)
- …in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. ... patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health… 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... license; full, active, and unrestricted license as a Registered Nurse in one of any US… more
- HCA Healthcare (Thousand Oaks, CA)
- …Care role today!** **Job Summary and Qualifications** The Clinical Nursing Manager is a registered nurse who reports directly to the unit Director or Chief ... for monitoring the delivery of patient care through the utilization of the nursing process, physicians' orders, established policies...of nursing; BSN desired, MSN preferred. + Current California Registered Nurse License. + Current BCLS and… more