- Providence (Mission Hills, CA)
- **Description** Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective ... them. **Required qualifications:** + Nursing school graduate. + California Registered Nurse License upon hire + 3...License upon hire + 3 years of experience in utilization management and/or case management. + 3 years of… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -… more
- Molina Healthcare (Los Angeles, CA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Managed Care Utilization Management and knowledge… more
- UCLA Health (Los Angeles, CA)
- …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our UCLA ... coordination of care. In this role you will perform utilization review while assuring the delivery of...accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in… 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: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… 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 ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Fresenius Medical Center (Costa Mesa, CA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… 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 ... of an accredited School of Professional Nursing + Current RN license by the Board of Nurse ...career path, we encourage you to apply for our Registered Nurse Oncology opening. We review… more
- HCA Healthcare (Thousand Oaks, CA)
- …and personal growth, we encourage you to apply for our Registered Nurse Radiology Special Procedures opening. We promptly review all applications. Highly ... of the range. **Introduction** Do you have the career opportunities as a(an) Registered Nurse Radiology Special Procedures you want with your current employer?… more
- Prime Healthcare (Lynwood, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189323/case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Francis Medical Center… more
- HCA Healthcare (Thousand Oaks, CA)
- …in your career path, we encourage you to apply for our Registered Nurse OR First Assist opening. We review all applications. Qualified candidates will be ... below midpoint of the range. **Introduction** Do you have the career opportunities as a(an) Registered Nurse OR First Assist you want in your current role? We… 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 health plan...BSN or MSN degree, required * Current valid California RN license, required * Two or more years of… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
- Dignity Health (Northridge, CA)
- …programs integrate. + Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required. + Minimum two (2) ... Federal or State regulations pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care. + Understand how … more
- HCA Healthcare (Riverside, CA)
- …a balance of optimal care and appropriate resource utilization . **Requirements:** + Registered Nurse ( RN ) with current California license required, Case ... join an organization that invests in you as an RN Case Manager? At Riverside Community Hospital, you come...Management Certification or utilization review preferred + Associate's Degree minimum… more
- Dignity Health (Oxnard, CA)
- …of patient satisfaction. The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required by ... candidate without the required experience may be considered. + Current CA Registered Nurse ( RN ) license. + Excellent customer service and presentation skills… more
- Molina Healthcare (Long Beach, CA)
- …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... California residents preferred. California RN licensure required.** **Work Schedule: Monday thru Friday, 10:00AM to 7:00PM with some weekends and holidays. Pacific… more
- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training Physical Requirements Light… more
- Cedars-Sinai (Marina Del Rey, CA)
- …Duties and Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review . + Reviews care and treatment for appropriateness against ... Bachelor's or Master's Degree in Nursing, Preferred **License/Certification:** + Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... happen both inside our hospitals and out in the community. **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and… more