- UCLA Health (Los Angeles, CA)
- …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site ... coordination of care. In this role you will perform utilization review while assuring the delivery of...RN License and BLS certification + Recent experience in case management, utilization management and discharge planning… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200415/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (Anaheim, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/199249/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...related field or at least one year experience in case management, discharge planning or nursing management; + CCM… more
- Stanford Health Care (Palo Alto, CA)
- …Knowledge, Skills and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and ... delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational, and… more
- Dignity Health (Santa Maria, CA)
- …Abilities, and Training** * Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used * Proficient in application of clinical ... At least five (5) years of nursing experience **Preferred Licensure and Certifications** Certified Case Manager (CCM), Accredited Case Manager (ACM-RN),… 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...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- Sharp HealthCare (San Diego, CA)
- …**Essential Functions** + Collaboration and teamwork Provides consultation and direction for Case Manager Utilization Management, and non-clinical support ... End Time** Bachelor's Degree; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for ...area of specialty. + 2 Years clinical experience in Utilization Review , Discharge Planning and/or Case… more
- Humana (Sacramento, CA)
- …performance review , up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work at ... part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health knowledge and skills… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...an acute hospital setting. At least 2 years of Utilization Management/ Case Management experience in a hospital… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in...team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Certified Case Manager (CCM) - Commission for Case Manager Certification; Bachelor's Degree in Nursing; California Registered Nurse (RN) - CA Board of… more
- Sharp HealthCare (San Diego, CA)
- …care nursing experience or case management experience + 3 Years recent case management, utilization review , care coordination experience + California ... **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager … more
- Stanford Health Care (Palo Alto, CA)
- …Why work at Stanford Medicine | Stanford Health Care (SHC)? Are you a seasoned RN Case Manager with bedside or case management experience working within or ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review ...improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in… more
- Sharp HealthCare (Chula Vista, CA)
- …and cost effective care for patients throughout the continuum. The Clinical Case Manager facilitates and coordinates services with health care professionals ... patient's progress towards the achievement of quality and cost outcomes. The Clinical Case Manager is responsible for accurately completing a patient assessment… more
- Molina Healthcare (San Jose, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE**… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; Certified Case Manager (CCM) - Commission for Case Manager … more
- Providence (Anaheim, CA)
- **Description** Under the direction of the Utilization Supervisor/ Manager , this position is responsible for the distribution, review , accurate and timely ... Certification (CMA) upon hire. + 1 year of experience in utilization management or case management with experience in medical terminology and coding. **Why Join… more
- Sutter Health (Goleta, CA)
- …and collaborates with interdisciplinary team to assure timely discharge. * Maintains an average Utilization Review (UR) accuracy rate at or above the goal. * ... RN-Registered Nurse of California BLS-Basic Life Support Healthcare Provider CCM - Certified Case Manager (certification may be required by entity and time to… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …nursing degree preferred. * Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. * Per Diem ... experience and internal equity. Position Summary: * Reports to the Director of Case Management * Plan, organize and deliver utilization management activities for… more
- Sharp HealthCare (La Mesa, CA)
- …acute care nursing experience or case management experience. + 3 Years case management, utilization review , care coordination experience. + California ... Start Time** **Shift End Time** Master's Degree; Bachelor's Degree in Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA);… more