- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …education, orientation, competencies & providing quality improvement & enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, & ... residents with oversight of licensed vocational nurses/nursing assistants as appropriate to the setting. The nurse will assist in directing the provision of nursing… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …21 sites. Responsibilities VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for ... from any US State or territory General Description of Assigned Duties: The Nurse IV Chief of Mental Health (MH) Service executes leadership that is characterized… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …Command Center, participates in daily interdisciplinary team meetings, engages in the utilization management review process, and may participate in rounds on ... EDRP participants ineligible to apply. Responsibilities The Clinical Command Center (CCC) Nurse Practitioner at the VA Palo Alto Health Care System (VAPAHCS)… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …four Licensed Clinical Social Workers, a Recreation Therapist, a Registered Nurse , a supervisor Addiction Therapist, and five Addiction Therapists. The primary ... Workers. The SUDP Psychologist Program Manager has overall responsibility for the operation and management of all SUDP programs. In addition to this there is a need… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- Summary The Registered Nurse falls under Women's Health Clinic in the Specialty Care Outpatient Service. The incumbent is accountable for all elements of the nursing ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- Summary The Surgical Nurse Practitioner, is responsible for surgical care for any of the subspecialty surgical sections to include; General Surgery, Vascular, ... others in the process improvement activities. Identifies and assesses resource utilization and safety issues, takin appropriate action. VA offers a comprehensive… more
- CVS Health (Sacramento, CA)
- …previous experience, - Call center experience - Multi-tasking experience - Prior remote experience - Case Management experience - Prior authorization experience ... and affordable. **Position Summary** This position is a 100% remote , work from home in the USA opportunity and...and will not be patient facing. The Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)… more
- Rady Children's Hospital San Diego (San Diego, CA)
- **GASTROENTEROLOGY Outpatient Nurse ** POSITION DETAILS: Schedule: Days, 10 hour shifts (not remote ) FTE: Full Time, 40 hours per week, 80 per pay period JOB ... procedures to perform education and advice to patients, in clinic procedures and nurse run visits, manages patient requests and needs via telephone triage and… more
- Centene Corporation (Sacramento, CA)
- …Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Magellan Health Services (San Diego, CA)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided...Job Information Title Care Manager BH (CA licensure) - Remote Grade 24 Work Experience - Required Clinical Work… more
- Magellan Health Services (San Diego, CA)
- …manage and oversee activities of assigned care support teams. Experience with Care Management flows. Knowledge of utilization management procedures, mental ... appropriate and effective person-centered care plan, member education and care management . Conducts initial and concurrent review for prior authorization of higher… more
- Cedars-Sinai (CA)
- …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... Doing** The Case Manager is responsible for the case management of patient while hospitalized and upon discharge from...are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF's… more
- UCLA Health (Santa Monica, CA)
- …main functions: 1. Resource and complex care coordination 2. Project coordination/ management for innovative approaches to deliver behavioral health services to ... needs. You will aim to foster continuity of care and reduce unnecessary utilization of healthcare services by coordinating and providing health services that meet… more
- Elevance Health (Costa Mesa, CA)
- …**Preferred skills, qualifications and experiences:** + Prior experience in inpatient Utilization Management , preferred. + Knowledge and/or experience of MCO, ... **Be Part of an Extraordinary Team** **Medical Management Clinician Senior** **Location: Remote -** Candidates...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes.… more
- Evolent (Sacramento, CA)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Stanford Health Care (Palo Alto, CA)
- …in clinical research, research, ICU, other intensive care setting, pediatrics, case management or nurse navigation preferred + Human subjects' protection and ... with minimal directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization knowledge in… more
- Elevance Health (Cerritos, CA)
- …reviews of high-tech diagnostic imaging, cardiac testing and sleep management services. Medical Directors in Clinical Operations determine the medical ... necessity of outpatient radiology, cardiology, sleep management , endoscopies and surgical site of care requests using...and consistent medical decisions to members and providers. **Location:** Remote . The ideal candidate will live within 50 miles… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …co-workers and hospital staff. The duties of this position vary widely requiring utilization of different processes and methods to accomplish this work. The work ... to: Scheduling, canceling, re-scheduling patient's appointments and/or consults. Consult/referral management . Answering and handling incoming and outgoing telephone calls… more