- Blue Shield of California (Long Beach, CA)
- …care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities ... Senior Care Manager will report to the Manager of Care Management . In this role...of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in… more
- Blue Shield of California (Los Angeles, CA)
- …care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities ... outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population...of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in… more
- Equiliem (Orange, CA)
- …BHT services from behavioral health providers. They are also responsible for utilization management , quality reviews and monitoring activities of BHT services. ... by communicating the Medical Director's decision and documents follow-ups in the utilization management system. Completes required documentation for data entry… more
- Cedars-Sinai (Los Angeles, CA)
- …annually thereafter as a condition of continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager - 8 Hour Days Per ... Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates...required. **Experience:** + Minimum of 2 years experience in Case Management preferred + Minimum of 3… more
- Prime Healthcare (Anaheim, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/170050/ case - manager utilization - management ... Bachelor degree in a related field or at least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ case - manager %2c-rn utilization ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager , you will play a key role in processing ... a vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... (BSN) degree required + Five or more years of utilization management required + Four or more...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- LA Care Health Plan (Los Angeles, CA)
- …years of varied clinical experience in an acute hospital setting. At least 2 years Utilization Management / Case Management experience in a hospital or HMO ... Utilization Management Nurse Specialist RN II...Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Utilization Management Representative II **Job Description:** ** Utilization Management ... Alto, Walnut Creek, Rancho Cordova and Sacramento, CA.** The ** Utilization Management Representative II** is responsible for...of community resources and social determinants of health. + Case management experience. + For URAC accredited… more
- Prime Healthcare (Inglewood, CA)
- …Responsibilities The working Manager of Case ... Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators… more
- Pipeline Health System, LLC (Huntington Park, CA)
- The RN Case Manager (CM) performs a wide...and wise utilization of resources. + Documents case management activities in the patient record ... prepared a plus. + Minimum of 2-3 years in Case Management Acute Care setting Licensure/Certifications: +...Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified Case… more
- Pipeline Health System, LLC (Gardena, CA)
- …coordination of patient care and wise utilization of resources. + Documents case management activities in the patient record and in the required information ... our hospitals for quality care. Job Summary: The RN Case Manager (CM) performs a wide variety...utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient… more
- Providence (Anaheim, CA)
- …in Oncology, Rehab, Pediatrics, Transplant, or Wound Care. + 3 years Experience in utilization management or case management . **Why Join Providence?** ... Master's Degree Related field. + upon hire: Certification in Case Management (CCM, ACM). + upon hire:...time **Job Shift:** Day **Career Track:** Nursing **Department:** 7520 CASE MANAGEMENT CA HERITAGE SERVICES **Address:** CA… more
- Cedars-Sinai (Marina Del Rey, CA)
- …+ ED Case Management experience, Strongly preferred **Working Title:** RN Case Manager , Emergency Dept - Per Diem, 12-hour Night Shift - Marina del ... the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services), you will be...will be responsible for the coordination and implementation of case management strategies pursuant to the … more
- Edwards Lifesciences (Irvine, CA)
- …cross-functionally, you will lead development, launch, and management of the case scheduling process to ensure efficient utilization of resources to meet ... reports, and other analyses to provide deep insights into Case Scheduling for better business planning and management... Case Scheduling for better business planning and management decision making. + Development & governance of the… more
- Amergis (Torrance, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making...in state practicing + At least one year of Case Management experience preferred + Complies with… more
- Molina Healthcare (Long Beach, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is required for this role. ... Experience with Case Management is a plus._** **_This is...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current… more
- UCLA Health (Los Angeles, CA)
- …Health Nursing staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + ... safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care.… more