- Dignity Health (Woodland, CA)
- …Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level ... - Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review prior authorizations for medical determination, preferred. - Bachelors… more
- Prime Healthcare (Anaheim, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/231079/ registered - nurse %2c- rn… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/227408/ registered - nurse %2c- rn… more
- Cognizant (Sacramento, CA)
- …role expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Cedars-Sinai (Beverly Hills, CA)
- …assessing their needs, coordinating care, communicating with health plans (including concurrent review , which assists the hospitalist/specialist and case manager ... of previous experience in case management, discharge planning, utilization review , and HMO in the acute inpatient ...ID** : 12522 **Working Title** : Lead Case Manager RN - Inpatient Specialty Program - 8-Hour… more
- Cedars-Sinai (Beverly Hills, CA)
- …by assessing their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered ... discharge from various care settings. In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the RN ...of care and level of care. Use evidence based review guidelines to conduct utilization review as… 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 ... equipment, and other discharge needs. Provides support to the inpatient review team as necessary to ensure...to, placement (with level of care) criteria (MCG, InterQual), concurrent review , and discharge planning. Preferred: Consistent… more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct… more
- UCLA Health (Santa Monica, CA)
- …high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care. ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...teams + Knowledge of a large university teaching hospitals Inpatient general medicine experience within a teaching hospital and… more