- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/173003/* case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be ... follows the UR process as defined in the Utilization Review Plan in accordance with the...continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager -… more
- Prime Healthcare (Anaheim, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/170050/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...related field or at least one year experience in case management, discharge planning or nursing management; + CCM… 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 and ... vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… 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. ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees:… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...in an acute hospital setting. At least 2 years Utilization Management/ Case Management experience in a hospital… more
- Elevance Health (Los Angeles, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Utilization Management Representative II **Job Description:** ** Utilization Management Representative ... Palo Alto, Walnut Creek, Rancho Cordova and Sacramento, CA.** The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Pipeline Health System, LLC (Huntington Park, CA)
- The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management...Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified Case… more
- Pipeline Health System, LLC (Gardena, CA)
- …hospitals to available beds in our hospitals for quality care. Job Summary: The RN Case Manager (CM) performs a wide variety of tasks and functions. These ... include utilization review , discharge planning, care coordination and...Nursing + Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified… more
- HCA Healthcare (Thousand Oaks, CA)
- …Robles Regional Medical Center have the opportunity to make a real impact. As a(an) RN Case Manager II PRN you can be a part of change. **Benefits** Los Robles ... positive outcomes for your patients as a (an) RN Case Manager II PRN. We want your...of life and contain costs. Accomplishes these objectives through review and coordination of patient care during the pre-entry,… more
- Cedars-Sinai (Marina Del Rey, CA)
- …our community with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services), you will be responsible for the coordination ... Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review . + Reviews care and treatment...+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience**… more
- Amergis (Torrance, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart... information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly… more
- Molina Healthcare (Long Beach, CA)
- …are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge ... **_JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees:… more
- UCLA Health (Los Angeles, 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 ... + CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years of acute… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Certified Professional ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...Prepares reports for the Delegation Oversight Committees, Quality Committees, Utilization Management Committees, Sanctions Committees, Internal Compliance Committees, etc.… more
- Dignity Health (Northridge, CA)
- …(https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Care Coordinator Case Manager Northridge Hospital Medical Center ... pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care....Nursing (BSN)) or related healthcare field. preferred + Certified Case Manager (CCM), Accredited Case … more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more