- Merck & Co. (Los Angeles, CA)
- …P&L (revenue and expenses); works with other stakeholders (Customer Manager , Directors, Planners) to provide input on resource allocation decisions ... to the Customer including promotional positioning (support of appropriate utilization ) and/or provider quality and outcomes-based activities.Provides feedback to and… more
- Providence (Anaheim, CA)
- …Certification in Oncology, Rehab, Pediatrics, Transplant, or Wound Care. 3 years Experience in utilization management or case management . Why Join ... Qualifications: Bachelor's Degree Nursing or Master's Degree Related field. upon hire: Certification in Case Management (CCM, ACM). upon hire: Specialty… more
- Prime Healthcare (Anaheim, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/166076/ case - manager utilization - management ... Bachelor degree in a related field or at least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6… more
- LA Care Health Plan (Los Angeles, CA)
- …in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: ... current and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager … more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/163839/*rn- case - manager utilization ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... (BSN) degree required + Five or more years of utilization management required + Four or more...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 5-7 years of acute/clinical care experience. Minimum of 2 years experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- LA Care Health Plan (Los Angeles, CA)
- …appeals and grievances, delegation oversight, and/or CNA experience. At least 2 years of Utilization Management / Case Management experience in a hospital ... Utilization Management Nurse Specialist LVN II... Utilization Management Nurse Specialist LVN II Job Category: Clinical...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews… more
- LA Care Health Plan (Los Angeles, CA)
- …years of varied clinical experience in an acute hospital setting. At least 2 years Utilization Management / Case Management experience in a hospital or HMO ... Utilization Management Nurse Specialist RN II...Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Prime Healthcare (Inglewood, CA)
- …Responsibilities The working Manager of Case ... Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators… more
- Pipeline Health System, LLC (Gardena, CA)
- …coordination of patient care and wise utilization of resources. + Documents case management activities in the patient record and in the required information ... for quality care. Job Description & Requirements The RN Case Manager (CM) performs a wide variety...utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient… more
- Pipeline Health System, LLC (East Los Angeles, CA)
- …coordination of patient care and wise utilization of resources. + Documents case management activities in the patient record and in the required information ... Job Summary: The RN Case Manager (CM) performs a wide...utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient… more
- Providence (Anaheim, CA)
- …in Oncology, Rehab, Pediatrics, Transplant, or Wound Care. + 3 years Experience in utilization management or case management . **Why Join Providence?** ... Master's Degree Related field. + upon hire: Certification in Case Management (CCM, ACM). + upon hire:...time **Job Shift:** Day **Career Track:** Nursing **Department:** 7520 CASE MANAGEMENT CA HERITAGE SERVICES **Address:** CA… more
- UCLA Health (Santa Monica, CA)
- …solver with: + BSN or MSN + CA RN License and BLS + Recent experience in case management , utilization management and discharge planning + Minimum of ... quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and...to you to help drive performance improvement efforts. This Case Management position floats to various units… more
- Actalent (Los Angeles, CA)
- Largest national Medicaid Managed Care Organization is looking for a REMOTE RN Case Manager to join their growing team! Opportunity to make an impact with an ... a fast-paced environment! Requirements: + CA RN license + Case Management experience + Medicare or Medical...outcome * Assess the member's current health status, resource utilization , past and present treatment plan and services, prognosis,… more
- Amergis (Los Angeles, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making...in state practicing + At least one year of Case Management experience preferred + Complies with… more
- UCLA Health (Los Angeles, CA)
- …Health Nursing staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + ... quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and...teams + Knowledge of a large university teaching hospitals Case Management experience in an acute hospital… more
- Amergis (Los Angeles, CA)
- …hr days Mon-Fri 8a-5p The Case Manager is responsible for utilization reviews, resource management , discharge planning, treatment plan management and ... Case Manager - Travel or Local Local Rate- $2,080 weekly for 40 hr days Travel Rate- $2,300 for 40… more
- UCLA Health (Los Angeles, CA)
- …Health Nursing staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + ... safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care.… more
- Prime Healthcare (La Palma, CA)
- … Case Management Department under the direction of the assigned Case Manager /Social Worker in the development and implementation of the discharge plan. ... + Travel to local hospitals is required. + Knowledge in discharge planning/ utilization management / case management terminology and functions, in both… more
