- 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 ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review , membership in a professional… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/ utilization - review - nurse ... Required qualifications: + Possess an active CA Licensed Vocational Nurse (LVN) license. + Minimum (2) two years of...(2) two years of experience in acute hospital case management or equivalent. + Utilization Management… more
- CenterWell (Sacramento, CA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
- Prime Healthcare (Lynwood, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more