- Evolent (Sacramento, CA)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- HCA Healthcare (Thousand Oaks, CA)
- …is recognized. Submit your application for the opportunity below: Clinical Nurse Coordinator EmergencyLos Robles Regional Medical Center **Benefits** Los ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...encourage you to apply for our Clinical Nurse Coordinator Emergency opening. We promptly review … more
- UCLA Health (Los Angeles, CA)
- …of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or ... Description The Quality Management Nurse is responsible for conducting comprehensive facility site...regulatory audits for medical appropriateness by using established clinical protocols… more
- Cedars-Sinai (Los Angeles, CA)
- …across the Consortium. + Maintains close coordination between the home department and Clinical Efficiency & Value team to review outcomes of the programs, ... clinic. + Develops collaborative relationships with members of the Medical Staff to gain support for value-based programs, encourage...BLS certification **Req ID** : 9385 **Working Title** : Clinical Value Nurse Practitioner (NP) - Department… more
- Cognizant (Sacramento, CA)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more
- HCA Healthcare (Thousand Oaks, CA)
- … Center we support our colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator - CCU and access programs to assist with every stage ... of your career. **Benefits** Los Robles Regional Medical Center, offers a total rewards package that supports...gain certifications and job skills. Apply today for our Clinical Nurse Coordinator - CCU opening and… more
- Fresenius Medical Center (Bellflower, CA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los ... that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations ( Clinical ) is responsible for the daily oversight of clinical appeals and… more
- HCA Healthcare (San Jose, CA)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator- Coronary ICU and access programs to assist with every ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...gain certifications and job skills. Apply today for our Clinical Nurse Coordinator- Coronary ICU opening and… more
- Dignity Health (Northridge, CA)
- …and protection to help infants thrive. We are seeking a passionate and experienced Clinical Nurse Specialist to join our exceptional NICU team. As a Neonatal ... **Job Summary and Responsibilities** At Northridge Hospital Medical Center, we understand that the possibility of... Clinical Nurse Specialist, you will be a… more