- Elevance Health (Costa Mesa, CA)
- …years acute care clinical experience is required. **Preferred Qualifications** + Previous utilization review/ utilization management experience in a managed ... Costa Mesa, Los Angeles, Rancho Cordova, Sacramento, Walnut Creek, Woodland Hills** The Nurse Medical Management I is responsible to collaborate with healthcare… more
- Fresenius Medical Center (Garden Grove, CA)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... **POSITION FEATURES:** This is a full time RN role for our Garden Grove, CA surgery...adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other… more
- Molina Healthcare (Irvine, CA)
- …we are seeking a Nurse with previous experience in Prior Auth Utilization Management and knowledge of Interqual or MCG guidelines. CALIFORNIA LICENSURE IS ... **JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN)… more
- Actalent (Riverside, CA)
- …Clarify orders related to admission status and patient management . Essential Skills + Registered Nurse ( RN ) license. + Experience in an acute hospital ... Job Title: RN Case Manager Job Description The RN... Case Manager is responsible for providing comprehensive case management for patients in skilled nursing facilities. This role… more
- Providence (Orange, CA)
- …+ Coursework/Training: Graduate of an accredited school of nursing. + California Registered Nurse License upon hire. + 3 years Clinical experience ... **Description** **Care Manager RN at St Joseph Hospital-Orange in Orange, CA....Wound Care upon hire. + 3 years Experience in utilization management or case management .… more
- Molina Healthcare (Riverside, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is preferred for this role. ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Elevance Health (Costa Mesa, CA)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to...and initiatives. **Minimum Requirements:** Requires current active valid unrestricted RN license to practice as a health professional in… more
- Amergis (Orange, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service delivery, ... referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care… more
- Elevance Health (Costa Mesa, CA)
- …experience preferred + Bilingual preferred. + Discharged planning experience preferred. + Utilization Management experience preferred. + Case Management ... ** Nurse Case Manager II** **Location** : Woodland Hills,...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- HCA Healthcare (Riverside, CA)
- …care and appropriate resource utilization . **What qualifications you will need:** + Registered Nurse ( RN ) with current California license required, Case ... Hospital! **Job Summary and Qualifications** The Coordinator of Case Management ( RN CM) is responsible for promoting...Management Certification or utilization review preferred + Associate's Degree minimum required +… more
- Molina Healthcare (Irvine, CA)
- …to be successful for this role. Training skills helpful. Knowledge of Utilization Management processes, EMR systems and Health Information Exchange very ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...years in one or more of the following areas: utilization management , case management , care… more
- Providence (Orange, CA)
- …degree, clinical degree is preferred (MD, RN , DO) + Upon hire: California Registered Nurse License (preferred) + 7 years of experience Clinical Leadership + ... **QUALIFICATIONS** + Master's Degree in Nursing, Public Health, Business Administration, Medical Management , or a related field; or MD or, DO; or equivalent… more