- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Fresenius Medical Center (Bellflower, CA)
- …while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans ... looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and...for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator -… more
- Cedars-Sinai (Los Angeles, CA)
- …care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician ... of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required...for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist -… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/ rn -case-manager utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN … more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices.… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Dignity Health (Northridge, CA)
- …Service: A commitment to providing excellent customer service. **Job Requirements** Required + CA Registered Nurse ( RN ) License required. + Minimum of 3 ... Summary and Responsibilities** Are you a passionate and dedicated Registered Nurse looking to truly impact patients'... looking to truly impact patients' lives? As an ** RN Care Coordinator** , you'll be the driving force… more
- HCA Healthcare (Thousand Oaks, CA)
- …or spine experience is preferred. + Basic Cardiac Life Support (BLS) - **Required** + ( RN ) Registered Nurse License with the State of California - ... knowledge and expertise! **Job Summary and Qualifications** As a Registered Nurse , you will be responsible for...personal growth, we encourage you to apply for our RN II Ortho Spine opening. We promptly review… more
- Dignity Health (Oxnard, CA)
- …AHA BLS card **Skills** + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- HCA Healthcare (Thousand Oaks, CA)
- …If you find this opportunity compelling, we encourage you to apply for our RN Surgical First Assist opening. We promptly review all applications. Highly ... each individual is recognized. Submit your application for the opportunity below: RN Surgical First AssistLos Robles Regional Medical Center **Benefits** Los Robles… more
- University of Southern California (Glendale, CA)
- …PRO regulations, JCAHO standards and contractual agreements with insurers or outside review agencies. Minimum Education: Current RN license in the State ... of California, BSN preferred Minimum Experience/Knowledge: Recent experience in Utilization /Quality/Case Management in acute setting preferred Required License/Certification: Current… more
- HCA Healthcare (Thousand Oaks, CA)
- …Care role today!** **Job Summary and Qualifications** The Clinical Nursing Manager is a registered nurse who reports directly to the unit Director or Chief ... Fund that offers free employee-only coverage to full-time and part -time colleagues based on income. Learn more about Employee...of nursing; BSN desired, MSN preferred. + Current California Registered Nurse License. + Current BCLS and… more
- LA Care Health Plan (Los Angeles, CA)
- …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health… 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)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... time,** **with rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out of… more
- University of Southern California (Arcadia, CA)
- …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review /case management in an ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- Fresenius Medical Center (Anaheim, CA)
- …priority management, and recommendation and implementation changes of current methods. + Review and comply with the Code of Business Conduct and all applicable ... of service being provided to the customers. + In-depth review with direct reports on the data retrieved from...for improvement eg Compliance, Billing, and Quality Indicators. + Utilization of data to better understand their business unit(s)… more
- HCA Healthcare (Thousand Oaks, CA)
- …satisfaction and personal growth, we encourage you to apply for our Operating Room Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We...you to join Los Robles Surgery Center which is part of the nation's leading provider of healthcare services,… more