• Utilization Management Nurse

    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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
    LA Care Health Plan (11/09/24)
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  • Managed Long Term Services and Supports…

    LA Care Health Plan (Los Angeles, CA)
    Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department: Managed Long Term Services and Supports Location: Los Angeles, ... Summary The Managed Long Term Services and Supports (MLTSS) Nurse Specialist RN II applies advanced clinical...and must adhere to regulatory mandates that apply to Utilization Management (UM) and Care Management more
    LA Care Health Plan (10/25/24)
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  • Customer Solution Center Appeals and Grievances…

    LA Care Health Plan (Los Angeles, CA)
    …Grievance (A&G) program for LA Care Health Plan members under the direct supervision and management of the A&G Nurse Specialist , RN and/or Medical Director. ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category:...documentation in the A&G system of record. Work with Utilization Management and PNO to facilitate completion… more
    LA Care Health Plan (11/04/24)
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  • Temporary Coordinator - Utilization

    ManpowerGroup (Rancho Cucamonga, CA)
    … Department. + Communicate with providers in consultation with the Utilization Management Nurse , regarding authorizations, modifications, denials, ... **Job Title: Utilization Management Outpatient** **Duration: 6 months**...three (3) years of experience as a data entry specialist or coordinator + High school diploma or GED… more
    ManpowerGroup (11/05/24)
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  • Registered Nurse II - North County

    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 COUNTY ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...practice setting. + Serves as a preceptor: expert or specialist who gives practical experience and training to new… more
    The County of Los Angeles (09/30/24)
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  • Clinical Documentation Integrity Peds…

    UCLA Health (Los Angeles, CA)
    …of clinical hospital experience; or equivalent of education and experience in case management , utilization management or prior clinical documentation review ... assisting with appropriate documentation strategies. Partnering with Medical Coding, Case Management and the Quality team, you will gather/analyze information to… more
    UCLA Health (10/30/24)
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  • Medical Director of Mental Health MDN

    Cedars-Sinai (Los Angeles, CA)
    …and vetting of any community MH provider as needed. + Supports and advises Utilization Management , CS 360, and population health teams as needed, including ... Care model that currently exists to support primary care physicians and their management of patients with mild to moderate depression and anxiety. This includes… more
    Cedars-Sinai (10/18/24)
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  • Medical Case Manager (LVN)

    Amergis (Orange, CA)
    …referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care ... to help accomplish goals; acts as a liaison between primary careproviders, specialist , and/or patient + Advocates on behalf of patient regarding accessibility… more
    Amergis (11/07/24)
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