- 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 necessity ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality - related job preferred.… more
- LA Care Health Plan (Los Angeles, CA)
- …verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or ... Utilization Management Admissions Liaison RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Ventura County (Ventura, CA)
- Registered Nurse II - Hematology Oncology...care as indicated and required. + May participate in quality assurance / utilization review or other ... (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5011691) Apply Registered Nurse II - Hematology Oncology (Regular &… more
- Ventura County (Ventura, CA)
- …Health Care Agency - Ventura County Medical Center/ Santa Paula Hospital APPROXIMATE SALARIES: Registered Nurse II ( RN II): $51.30 - $61.35 per hour ... Registered Nurse II - Emergency Department...care as indicated and required. + May participate in quality assurance / utilization review or other… more
- Ventura County (Ventura, CA)
- …attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per Diem Print… more
- Ventura County (Ventura, CA)
- …assistance and patient care as indicated and required. + May participate in quality assurance / utilization review or other non-direct patient care nursing ... Per Diem Registered Nurse III - Emergency Services...Per Diem Registered Nurse III - Emergency Services - Santa Paula...Nurse will be responsible for providing rapid and high- quality nursing care to patients and to the community… more
- Ventura County (Ventura, CA)
- …assistance and patient care as indicated and required. + May participate in quality assurance / utilization review or other non-direct patient care nursing ... Registered Nurse II - ICU/DOU/Telemetry (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4887199) Apply Registered … more
- Ventura County (Ventura, CA)
- …attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... Registered Nurse II - Pre-op/PACU Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5088990) Apply Registered Nurse II - Pre-op/PACU… more
- Ventura County (Ventura, CA)
- …your full-time registered nursing experience with case management, disease management, quality assurance , and/or utilization review. In your response, ... including two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance , HEDIS and/or Utilization Review. NECESSARY SPECIAL… more
- Ventura County (Ventura, CA)
- …+ Attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... CANDIDATE The ideal candidate is a compassionate, adaptable, and clinically skilled registered nurse who excels in delivering comprehensive care to patients… more
- Sutter Health (San Francisco, CA)
- …+ Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case Manager ... Services (GR) Grouper (CMS), Department of Managed Health Care, National Committee for Quality Assurance (NCQA). + A broad knowledge base of outpatient, acute,… more
- Stanford Health Care (Palo Alto, CA)
- …models of case management, including the principles and practices of discharge planning, utilization review, and quality assurance /improvement + Knowledge of ... as required; collects, analyzes and reports on data for utilization , quality improvement, compliance, and other areas...outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse -… more
- Sharp HealthCare (San Diego, CA)
- …in Patient Safety (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse ( RN ) - CA Board of Registered ... Degree; Bachelor's Degree in Nursing; Certified Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality...Board for Professionals in Patient Safety -PREFERRED + California Registered Nurse ( RN ) - CA… more
- Sharp HealthCare (San Diego, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... RN experience in related clinical area. + California Registered Nurse ( RN ) - CA...regarding quality clinical and service standards. Coordinates Quality Assurance program for each department. Tracks… more
- CommonSpirit Health (Rancho Cordova, CA)
- …within the organization to expedite this process. Primary responsibility for completing quality assurance reviews of work performed and communicating with ... **Job Summary and Responsibilities** **I** **CU** ** RN , Emergency Room RN or Level...barriers. **Accountabilities:** + Compiles data for the purpose of quality assurance and compliance with organizational and… more
- CommonSpirit Health (Rancho Cordova, CA)
- …within the organization to expedite this process. Primary responsibility for completing quality assurance reviews of work performed and communicating with ... **Job Summary and Responsibilities** **ICU RN , Emergency Room RN or Level...**Core Duties:** + Compiles data for the purpose of quality assurance and compliance with organizational and… more
- Stanford Health Care (Palo Alto, CA)
- …of case management, including the principles and practices of discharge + planning, utilization review, and quality assurance /improvement + Knowledge of the ... records as required; collects, analyzes and reports ondata for utilization , quality improvement, compliance, and other areas...outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse -… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA...LeadershipManages UM operations in accordance with National Committee on Quality Assurance (NCQA) and Health Plan requirements.Develop… more
- The County of Los Angeles (Los Angeles, CA)
- …casting. + Evaluates assessment data to define health and developmental problems. + Conducts quality assurance studies of chart documents and the quality ... accredited college or university . LICENSE(S) REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a Nurse Practitioner… more
- Alameda Health System (Oakland, CA)
- …accrediting agencies. Monitors the regularity of programs providing for infection control, quality assurance , continuity of care, teaching of patients, and ... the determination and implementation of patient care and documentation standards and quality assurance program criteria and monitors the documentation of their… more