- 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
- Sharp HealthCare (Chula Vista, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... nursing expert for assigned area. **Required Qualifications** + California Registered Nurse ( RN ) - CA...errors; have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of… more
- Sharp HealthCare (San Diego, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... nursing expert for assigned areas. **Required Qualifications** + California Registered Nurse ( RN ) - CA...errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of… 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
- Actalent (Rancho Cordova, CA)
- …+ Strong computer skills. + Excellent communication skills. + Experience in utilization review , utilization management, prior authorization, case management, ... Prior Authorization RN FULLY REMOTE- MUST reside in California Great...healthcare to all Californians! Job Description The Prior Authorization Nurse will triage and review cases as… 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
- 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
- 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
- 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
- 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