- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- LA Care Health Plan (Los Angeles, CA)
- …Grievance (A&G) program for LA Care Health Plan members under the direct supervision and management of the A&G Nurse Specialist , RN and/or Medical Director. ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category:...documentation in the A&G system of record. Work with Utilization Management and PNO to facilitate completion… more
- ManpowerGroup (Rancho Cucamonga, CA)
- … Department. + Communicate with providers in consultation with the Utilization Management Nurse , regarding authorizations, modifications, denials, ... **Job Title: Utilization Management Outpatient** **Duration: 6 months**...three (3) years of experience as a data entry specialist or coordinator + High school diploma or GED… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …work experience License/Certification: CA Registered Nurse (RN), CNS - Clinical Nurse Specialist certified by the California Board of Registered Nursing. ... summarizes the general nature, level and purpose of the job. Clinical Nurse Specialists are Master's Degree prepared advanced practice Registered Nurses in roles… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …position requires registered nursing bedside experience. JOB SUMMARY: The Value Analysis Specialist plays a crucial role in optimizing cost-efficiency and quality in ... the procurement and utilization of medical supplies and equipment. This position requires a dedicated professional who can evaluate, analyze, and recommend… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more
- Sharp HealthCare (San Diego, CA)
- …scheduling. The Sr. Specialist is a key member of the site Utilization Management Committee. **Required Qualifications** + Bachelor's Degree in Nursing + 3 ... the position, and employer business practices. **What You Will Do** The Sr. Specialist Inpatient Care Management drives clinical interventions and care planning… more
- Alameda Health System (Oakland, CA)
- Care Management Specialist + Oakland, CA + Highland...in a health care field or one year in Utilization Management at a Medical Group or Health ... discharge services. 5. Per the direction of the Care Management social worker and/or nurse , facilitates, identifies...GED Required Experience: One year experience in a case management specialist position in an acute care… more
- ERP International (Vandenberg AFB, CA)
- …algorithms, CM software, and databases for community resources + Integrate CM and utilization management (UM) and integrating nursing case management with ... Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS) or Association of Rehabilitation Nurses:… more
- Sharp HealthCare (San Diego, CA)
- …Association for Healthcare Quality; Certified Professional in Healthcare Risk Management (CPHRM) - American Hospital Association; Certified Professional in Patient ... (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing;… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH COUNTY ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...practice setting. + Serves as a preceptor: expert or specialist who gives practical experience and training to new… more
- ERP International (Twentynine Palms, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS) o Association of Rehabilitation Nurses:… more
- Edwards Lifesciences (San Francisco, CA)
- …difference to patients around the world. As a part of the Field Clinical Specialist team, you will be a critical part of delivering our patient focused innovations, ... Quality, Regulatory, and Education. After extensive training, a Field Clinical Specialist will travel frequently within an assigned territory, clinically training… more
- UCLA Health (Los Angeles, CA)
- …of clinical hospital experience; or equivalent of education and experience in case management , utilization management or prior clinical documentation review ... assisting with appropriate documentation strategies. Partnering with Medical Coding, Case Management and the Quality team, you will gather/analyze information to… more
- Stanford Health Care (Palo Alto, CA)
- …professional growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified ... (1) year of experience as a licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered … more
- Sharp HealthCare (La Mesa, CA)
- …on identified patients as directed.Performs order entry and pharmaceutical care management as directed.Demonstrates proficiency with and utilization of ... of Pharmacy Specialties; Doctor of Pharmacy (PharmD); BPS Board Certified Pharmacotherapy Specialist (BCPS) - Board of Pharmacy Specialties; AHA Basic Life Support… more
- Amergis (Redding, CA)
- …regarding accessibility of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in outreach activities to ... continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential… more
- Cedars-Sinai (Los Angeles, CA)
- …and vetting of any community MH provider as needed. + Supports and advises Utilization Management , CS 360, and population health teams as needed, including ... Care model that currently exists to support primary care physicians and their management of patients with mild to moderate depression and anxiety. This includes… more
- Amergis (Redding, CA)
- …referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care ... to help accomplish goals; acts as a liaison between primary careproviders, specialist , and/or patient + Advocates on behalf of patient regarding accessibility… more