- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical… more
- Cedars-Sinai (CA)
- …or 1 year inacute care nursing ( Medical Surgical/Tele/ICU) with 2 or more year ofcare management experience ( UM or DC Planning). + At least 3 years of Case ... Management experience preferred + Knowledge of medical ...email address. **Req ID** : 13034 **Working Title** : Registered Nurse - Care Coordinator - 8… more
- Cedars-Sinai (CA)
- … Surgical/Tele/ICU) with 2 or more year of care management experience ( UM or DC Planning). + Knowledge of medical literature, research methodology, health ... for Hiring. **Req ID** : 12784 **Working Title** : Registered Nurse - Care Coordinator - 8...Care Coordinator - 8 Hour Days **Department** : Case Management **Business Entity** : Cedars-Sinai Medical Center… more
- CVS Health (Sacramento, CA)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- LA Care Health Plan (Los Angeles, CA)
- …for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted California ... required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN ...Works with UM leadership, including the Utilization Management Medical Director, on requests where determination… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Actalent (Santa Barbara, CA)
- … Coordinator - REMOTE POSITION Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract ... Health Plan Nurse Coordinator (HPNC) is a Registered Nurse assigned to one of several...Confidentiality laws and regulations. + Adhere to Health Plan, Medical Management , and Health Services policies and… more
- Dignity Health (Santa Maria, CA)
- … Management or Nursing field in lieu of 1 year experience. + Current California Registered Nurse ( RN ) license. + Graduate of an accredited school of ... (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed care and… more
- Molina Healthcare (Los Angeles, CA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** * At least… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... management activities to include tracking, trending and analyzing UM data. Works in collaboration with regional medical...experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA… more