- Providence (Mission Hills, CA)
- …empower them. **Required qualifications:** + Associate's Degree in Nursing. + Upon hire: California Registered Nurse License + 2 years of experience working in a ... **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records… more
- Select Medical (Los Angeles, CA)
- …Medical Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more
- Elevance Health (Los Angeles, CA)
- …care for wound care. + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written authorizations to ... do not meet coverage guidelines criteria to Physician for review . + Uses clinical judgment in authorizations that fall...provides an equivalent background. + Current active valid unrestricted RN license to practice as a health professional within… more
- Providence (Santa Monica, CA)
- …approval for, implement and monitor a model for integrated coordination function, involving registered nurse , and social work case managers and other relevant ... professionals that measurably improve performance. + Create, and analyze utilization review metrics, maintained in the form...goals and outcomes. **QUALIFICATIONS** + Graduate of a recognized registered nurse program + Master's Degree in… more
- The County of Los Angeles (Los Angeles, CA)
- …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL… more
- Elevance Health (Los Angeles, CA)
- …on relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians. **How you will ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid...experience. + Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health… more
- Actalent (San Fernando, CA)
- Entry Level Registered Nurse Hiring Now! Responsibilities + Responsible for functioning as the liaison among all parties involved with the patient + P ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., - patient financial… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... clients most prone to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions + Interviews the… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... most prone to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions + Administers, either… more
- Elevance Health (Los Angeles, CA)
- …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
- Elevance Health (Los Angeles, CA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... The Med Mgmt Nurse CA is responsible for review ...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more