- Rising Medical Solutions (Los Angeles, CA)
- …nursing, medical case management, occupational health, orthopedics, home health care, utilization review , or quality assurance + Familiarity with regional ... Advance Your Career with Rising Medical Solutions Are you an experienced workers ' compensation nurse case manager eager to bring your expertise to a team that's… more
- Sutter Health (San Francisco, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The RN Case… 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...valid, current license to practice as a clinical social worker or marriage and family therapist issued by the… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...provides information to the department head as indicated. + Utilization review and utilization managementThe… 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
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... utilization of medical services within the parameters of the workers compensation benefits and/or Utilization decisions. This includes appropriate movement… more
- The County of Los Angeles (Los Angeles, CA)
- …a clinical social worker , marriage and family therapist, psychologist, or registered nurse issued by the appropriate State of California licensing agency - AND - ... a clinical social worker , marriage and family therapist, psychologist, or registered nurse issued by the appropriate State of California licensing agency - AND -… 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
- Alameda Health System (Oakland, CA)
- …contracted vendors. + Responsible for the coordination and support of the AHS Utilization Review Committee. + Responsible for overseeing patient, physician and ... manages the collection, analysis and presentation data relevant to the utilization of healthcare resources, including but not limited to avoidable/variance days,… more