- Elevance Health (CA)
- …on relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior clinicians. **How you will ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
- VNA Health (Santa Barbara, CA)
- …58/hr PLUS a $5,000 sign on BONUS! Job Description: VNA Health is looking for compassionate Registered Nurse Case Managers ( RN CM) to join our Home Health ... care team. The RN CM plans, organizes and directs home care services....directs home care services. Responsibilities: + Responsible for continuous review of all aspects of every patient on his/her… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more
- Ventura County (Ventura, CA)
- …every stage of their journey. THE POSITION: Under direction of a physician or registered nurse , the Field Based Psychiatric Technician performs a variety of ... practice as a licensed Psychiatric Technician or Licensed Vocational Nurse (LVN) in the state of California. This is...and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in… 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
- Evolent (Sacramento, CA)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Admissions Liaison RN II...Management Medical Director, on requests where determination requires extended review . Collaborates with the inpatient care team for facilitation/coordination… more
- Ventura County (Ventura, CA)
- …CANDIDATE The ideal candidate is a compassionate, adaptable, and clinically skilled registered nurse who excels in delivering comprehensive care to patients ... consistently demonstrating empathy and effective collaboration. PAYROLL TITLES AND APPROXIMATE SALARIES: Registered Nurse II: $52.07 - $62.27 hourly Per Diem … more
- Ventura County (Ventura, CA)
- …Care Unit (NICU), Pediatrics Intensive Care Unit (PICU), or Pediatrics (Peds). The registered nurse performs the full range of professional nursing duties. ... Per Diem Nurse is distinguished from the Registered Nurse classification in that Per Diem...records and prepares reports; + May participate in quality assurance/ utilization review or other non-direct patient care… more
- Elevance Health (Walnut Creek, CA)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... is granted as required by law._** The **Medical Management Nurse ** is responsible for review of the...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more