- Molina Healthcare (Long Beach, CA)
- …setting + 5+ years of clinical correspondence processing and quality review experience + **Bilingual- Spanish** + ** UM experience** To all current Molina ... **Job Description** **Job Summary** The Clinical Correspondence Review Nurse...are seeking a candidate with a RN license and UM experience. Prior Case Management experience highly preferred. Strong… 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 Position Type: Full Time ... setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family interaction… more
- Cedars-Sinai (Beverly Hills, CA)
- …Additionally, providing clinical support and oversight for all utilization management ( UM ) activities on an ongoing basis, in accordance with CSMCF policies and ... pharmacists, nurses and other health care professionals. Some patient correspondence may occur. + Assist with training of pharmacy...as requested. + With the team, develops and implements clinical criteria for the review of non-formulary… more