- Martin Luther King, Jr. Community Hospital (Los Angeles, CA)
- …information to payors. The role integrates and coordinates the functions of utilization management , care progression and care transition. The Case Manager ... Highly preferred: One (1) year m inimum of RN Case Management inpatient OR two...needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include:… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- UCLA Health (Los Angeles, CA)
- Description As the Utilization Management & Quality Review Nurse , you will be responsible for: + Ensuring appropriate, cost-effective, and high-quality care ... for New Century Health Plan members + Conducting utilization management (UM) activities in accordance with...BSN or MSN degree, required * Current valid California RN license, required * Two or more years of… more
- Cedars-Sinai (Los Angeles, CA)
- …Motions, Eye/Hand/Foot Coordination **Req ID** : 1074 **Working Title** : Registered Nurse - Utilization Management - Per Diem Days **Department** : ... of an accredited nursing program Bachelor's Degree Nursing **Licenses:** RN State License Basic Life Support (BLS) **Experience:** 3... Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more
- Elevance Health (Los Angeles, 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
- Pipeline Health System, LLC (Gardena, CA)
- Case Manager Registered Nurse RN - Per Diem 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. These include ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient progression, and… more
- Molina Healthcare (Long Beach, CA)
- **_JOB TITLE: RN ( REGISTERED NURSE ) Program...years in one or more of the following areas: utilization management , case management , care ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN… more
- Pipeline Health System, LLC (Huntington Park, CA)
- RN Case Manager - Registered Nurse Per Diem 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. These include ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient progression, and… 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: ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...experience* at the level of Los Angeles County classification Registered Nurse I**. -AND- 2. A license… more
- HCA Healthcare (Thousand Oaks, CA)
- …Regional Medical Center! **Job Summary and Qualifications** The **Oncology Registered Nurse ** II performs direct patient care through utilization of the ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Oncology you want in your...of an accredited School of Professional Nursing + Current RN license by the Board of Nurse … more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- Summary The Intensive Community Mental Health Recovery (ICMHR) Registered Nurse ( RN ) is responsible for providing competent, evidence-based care to patients. ... The ICMHR program provides clinical community-based case management services to Veterans with pervasive mental illness (PMI),...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Providence (Mission Hills, CA)
- …Degree in Nursing or other related area + Upon hire: California Registered Nurse License + 5 years Healthcare management experience related to acute care ... **Description** The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management … more
- Providence (Mission Hills, CA)
- … Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical...**Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2… more
- LA Care Health Plan (Los Angeles, CA)
- …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... unrestricted California License Licenses/Certifications Preferred Required Training Required: Registered Nurse ( RN ) Physical Requirements Light Additional… more
- Dignity Health (Northridge, CA)
- … programs integrate. + Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required. + Minimum two (2) years ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Molina Healthcare (Los Angeles, 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
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Required: Knowledge of state, federal and regulatory requirements in Appeals/Care/Case/ Utilization Management /Quality. Strong verbal and written communication… more
