- Alameda Health System (Oakland, CA)
- Nurse , Care Management + Oakland, CA + Highland General Hospital + HGH Care Coordination + Part Time - Day + Care Management + Req #:40544-29921 + FTE:0.5 + ... by each individual in the classification. 1. Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective… more
- Elevance Health (Walnut Creek, CA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of ... PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm **PST** The ** Nurse Appeals** is responsible for investigating and processing medical necessity… more
- Alameda Health System (San Leandro, CA)
- …the age and cultural or religious influences of the patient/family. 2 . Coordinates disposition of Medi-Cal, self-pay, and out-of-plan patients, including working ... Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or experience in case… more
- Veterans Affairs, Veterans Health Administration (Martinez, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... of eligible applications will be December 6, 2024 with subsequent cut-off dates every 2 weeks. Eligible applications received after that date will be accepted on an… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Licensed Vocational Nurse (LVN) - Community Living Center (CLC) is responsible for direct patient care activities under the direction of the Registered ... Nurse (RN). The LVN/LPN works in a self-directed manner...be November 18, 2024, with subsequent cut-off dates every 2 weeks. Eligible applications received after that date will… more
- Alameda Health System (Oakland, CA)
- …employee education files as needed for managers and/or any regulatory agencies. 2 . Assists AHS leadership team during regulatory hospital surveys with multiple ... leadership team to evaluate and complete the Periodic Performance Review (PPR) as required by the Joint Commission. 3....14. Participates in continuing education provider unit as a Nurse Planner; utilizes Board of Registered Nursing (BRN), The… more
- Alameda Health System (Oakland, CA)
- …Collaborates with AHS leadership team to evaluate and complete the Periodic Performance Review (PPR) as required by the Joint Commission. + Assists in organizing and ... revises competencies as needed to meet regulatory obligations. Develops annual educational review courses with post-tests or other validation methods for all staff… more
- Sutter Health (Castro Valley, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted ... Health related field or equivalent education/experience **CERTIFICATION & LICENSURE** + Registered Nurse - State Licensure - RN Required + Basic Life Support… more
- Alameda Health System (Oakland, CA)
- …such as PDCA, Lean, Six Sigma, and Statistical Process Control Analysis. 2 . Evaluates data, makes judgments, and recommendations regarding quality improvement work, ... systemwide Medical Staff quality and performance improvement activities such as Peer Review , OPPE, and FPPE as required by regulatory agencies. 10. Conduct in-depth… more
- Alameda Health System (San Leandro, CA)
- …in department meetings and operations, including process development or improvement. 2 . Assures clinical interventions are appropriate for the admitting diagnosis ... utilization and an appropriate level of care. 5. Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective … more
- Alameda Health System (Alameda, CA)
- …and other mandated regulations according to Department standards. Keeps required statistics. 2 . Reviews all the patients in his/her caseload in the following areas; ... Experience: One year related in acute care facility and/or utilization review training and/or healthcare experience. Minimum Experience: Varied clinical experience… more
- Ethos Veterinary Health (Concord, CA)
- …for the CCU department, you will be responsible for: + Continuously review and assess workload, formulating and implementing plans to ensure efficient and ... community of more than 1,500 specialized doctors providing care for nearly 2 million pets annually. The integrated and collaborative network of veterinary… more
- City and County of San Francisco (San Francisco, CA)
- …have its own separate application + City departments with open positions can review your application + Position-specific details will follow from them + Respond ... than 8,000 individuals over the course of the year. Our team of eight Nurse Practitioners and eight physicians provides a unique blend of urgent care including… more
- Alameda Health System (Oakland, CA)
- …information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services as ... by the care coordination nursing staff at all AHS acute care facilities. 2 . Communicates status with Utilization Management staff and arranges for patient transfer;… more
- Alameda Health System (Oakland, CA)
- …interactions with payors and communicates status with Care Management staff. 2 . Coordinates and obtains authorizations for admissions; documents all information in ... information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. 5.… more
- Alameda Health System (Alameda, CA)
- …is as outlined in the care plan and supported by documentation. 2 . Facilitates accurate determination of the Assessment Reference Date; Provides interdisciplinary ... a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited school of… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- …and skills needed to perform the duties of the position; OR, ( 2 ) Education. One year above high school; OR, (3) Experience/Education Combination. Equivalent ... coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability (utilization) to ensure that clinic schedules are… more
- Alameda Health System (San Leandro, CA)
- …public; requests and provides information regarding program rules, regulations and activities. 2 . Compiles figures for the preparation of the unit's budget; makes ... Long Term Care requirements for patient length of stay, nurse :patient care time; and other required regulatory reports specific...interoffice and external mail; may plan, assign, direct and review the work of a small office support staff.… more