- Sharp HealthCare (San Diego, CA)
- …(AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Vocational ... for the position, and employer business practices. **_T_** **_his is an LVN float pool position that services the following Sharp Rees-Stealy locations: San… more
- Molina Healthcare (WI)
- …or RN Nurse with previous experience in Concurrent Review/_** **_Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. COMPACT ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Sharp HealthCare (San Diego, CA)
- …0 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; IV Certification ... Downtown, Chula Vista, Santee, and La Mesa.** **As an LVN in this Float Pool, you would be trained...related to front desk responsibilities including scheduling and telephone management . Acts as a positive role model and ensures… more
- Sharp HealthCare (San Diego, CA)
- …credibility with physicians and non-physician health care practitioners involved in case management + California Licensed Vocational Nurse ( LVN ) - CA Board ... (CCM) - Commission for Case Manager Certification; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Bachelor's… more
- Banner Health (Tucson, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- The Cigna Group (Bloomfield, CT)
- …Responsibilities:** + Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient ... medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts. **Essential Duties… more
- Amergis (Orange, CA)
- The LPN/ LVN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... delivery, and compliance with medical regime. Essential Duties and Responsibilities: +...for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making… more
- Sutter Health (Concord, CA)
- …standards of practice Fiscal Responsibility (includes productivity, HHRG rating, supply management , utilization review) * Demonstrates ability to prioritize ... referral sources and community agencies * Demonstrates knowledge and appropriate utilization of internal, community resources to meet patient needs * Demonstrates… more
- Molina Healthcare (Los Angeles, CA)
- …within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including ... **Required Education** Completion of an accredited Licensed Vocational Nurse ( LVN ), or Licensed Practical Nurse (LPN) Program **Required Experience** +… more
- Elevance Health (KY)
- **Title** : Licensed Utilization Review II **Location** : Candidates must reside within 50 miles or 1-hour commute each way of an Elevance Health location. **Build ... the Possibilities. Make an Extraordinary Impact.** The **Licensed Utilization Review II** is responsible for working primarily with healthcare providers to help… more
- Elevance Health (Louisville, KY)
- The **Licensed Utilization Review I** is responsible for working with healthcare providers to help ensure appropriate and consistent administration of plan benefits ... licensure by utilizing appropriate medical policies and clinical guidelines in compliance with department guidelines and consistent with the members eligibility,… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …techniques. The LPN GS-7 will also assist NM with daily clinic flow, schedule management oversight, EOC compliance , EARR compliance , equipment management ... daily flow of PACTs, assure daily staff schedule is updated, and appointment management for PACTs is completed daily. Assist NM to develop mechanisms to continuously… more
- Molina Healthcare (IA)
- …including 3 or more years in one or more of the following areas: utilization management , case management , care transition and/or disease management ... programs providing ongoing communication of goals, evaluation, and support to ensure compliance with standardized protocols and processes. + May engage and oversee… more
- Integra Partners (Troy, MI)
- …Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management (UM) processes. The ideal candidate will have a ... industry standards, regulatory requirements, and best practices in clinical documentation and utilization management and update training documents as required +… more
- ChenMed (St. Louis, MO)
- …years' clinical work experience required + A minimum of 1 year of utilization review and/or case management , home health, discharge planning experience required ... S/he adheres to strict departmental goals/objectives, standards of performance, regulatory compliance , quality patient care compliance and policies and… more
- Molina Healthcare (San Francisco, CA)
- …position we are seeking a Nurse with previous experience in Prior Auth Utilization Management and knowledge of Interqual or MCG guidelines. CALIFORNIA LICENSURE ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Banner Health (Torrington, WY)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- Banner Health (Ogallala, NE)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- Banner Health (Sterling, CO)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- Banner Health (Tucson, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... physician orders and the nursing plan of care, in compliance with policies and procedures, standards of care, and...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
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