- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $113,309.04 -… more
- Prime Healthcare (Lynwood, CA)
- …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 ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/166682/case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Francis Medical Center… more
- UCLA Health (West Hills, CA)
- …or the equivalent of education and experience + Recent experience in case management, utilization management, or discharge planning + Current valid CA RN license ... + BLS from the ARC or AHA Preferred: + Knowledge of Interqual UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique… more
- Amergis (Los Angeles, CA)
- The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote ... as facility policy. Essential Duties and Responsibilities: + Performs utilization review in accordance with all state...+ Current license for the state in which the nurse practices if nursing licensure is required by contract… more
- Dignity Health (Northridge, CA)
- …nursing experience in an acute hospital setting required. + Current CA Registered Nurse ( RN ) license + Prior Utilization Management experience in a ... than 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for… more
- Cedars-Sinai (Los Angeles, CA)
- …us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be at the most ... Manager follows the UR process as defined in the Utilization Review Plan in accordance with the...from an accredited nursing program required. Bachelors Degree in Nurse preferred. California RN License required. **Experience:**… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and… more
- Molina Healthcare (Long Beach, CA)
- **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE ** **For this position we are seeking a ( RN ) Registered Nurse with ... previous experience in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA… more
- Molina Healthcare (Los Angeles, CA)
- **_For this position we are seeking a California ( RN ) Registered Nurse with 3 years+ Concurrent Review / Utilization Review / Utilization ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- The County of Los Angeles (Los Angeles, CA)
- …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL… more
- Pipeline Health System, LLC (Huntington Park, CA)
- …Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and variance management to ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management activities in...record and in the required information system. + The RN CM reports to the Director/Manager of the department.… more
- Pipeline Health System, LLC (Gardena, CA)
- …Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and variance management to ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management activities in...record and in the required information system. + The RN CM reports to the Director/Manager of the department.… more
- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training Physical Requirements Light… more
- Fresenius Medical Center (Harbor City, CA)
- **PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) ... for new employees who meet the RN CAP 2 criteria or attained through...the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs ongoing, systematic collection and analysis… more
- LA Care Health Plan (Los Angeles, CA)
- …(HMO) & Independent Practice Association (IPA) contracts and payers. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... achieve that purpose. Job Summary The Clinical Assurance Compliance Nurse Specialist RN II is responsible for the review of regulatory, contractual and… more
- Molina Healthcare (Los Angeles, CA)
- **NIGHT SHIFT WORK SCHEDULE:** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_PERMANENT SHIFT WILL BE A 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in ... will move to a 3 day/12 hour shift from then on._** **_Previous experience with Utilization Management / Utilization Review is very essential to this role.… more
- Fresenius Medical Center (South El Monte, CA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- HCA Healthcare (Thousand Oaks, CA)
- …Medical Center we support our colleagues in their positions. Join our Team as a(an) Registered Nurse II- Cardiac Rehab and access programs to assist with every ... gain certifications and job skills. Apply today for our Registered Nurse II- Cardiac Rehab opening and...for the Cardiac Rehab performs direct patient care through utilization of the nursing process in accordance with the… more
- Molina Healthcare (Long Beach, CA)
- …process._** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), ... this position we are seeking a (LVN / LPN) Nurse with previous experience in Case management, Acute Care,...with previous experience in Case management, Acute Care, Concurrent Review / Utilization Review / … more
- UCLA Health (Los Angeles, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more