- Alameda Health System (Oakland, CA)
- Nurse , Care Management + Oakland, CA + Highland General Hospital + HGH Care Coordination + Services As Needed / Per Diem - Day + Care Management + Req #:41209-30478 ... by each individual in the classification. 1. Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective… more
- Alameda Health System (Alameda, CA)
- AHD Registered Nurse - Park Bridge + Alameda, CA + Park Bridge + PB Nursing + Services As Needed / Per Diem - Evening + Nursing + Req #:40776-30113 + FTE:0.01 + ... Posted:January 29, 2025 **Summary** **SUMMARY:** The AHD Registered Nurse - Park Bridge provides direct nursing care to residents and supervises the patient care… more
- Elevance Health (Walnut Creek, CA)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the… more
- Alameda Health System (San Leandro, CA)
- …the age and cultural or religious influences of the patient/family. 2 . Coordinates disposition of Medi-Cal, self-pay, and out-of-plan patients, including working ... Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or experience in case… more
- Alameda Health System (Oakland, CA)
- …employee education files as needed for managers and/or any regulatory agencies. 2 . Assists AHS leadership team during regulatory hospital surveys with multiple ... leadership team to evaluate and complete the Periodic Performance Review (PPR) as required by the Joint Commission. 3....14. Participates in continuing education provider unit as a Nurse Planner; utilizes Board of Registered Nursing (BRN), The… more
- Alameda Health System (Oakland, CA)
- …Collaborates with AHS leadership team to evaluate and complete the Periodic Performance Review (PPR) as required by the Joint Commission. + Assists in organizing and ... revises competencies as needed to meet regulatory obligations. Develops annual educational review courses with post-tests or other validation methods for all staff… more
- Sutter Health (Castro Valley, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted ... Health related field or equivalent education/experience **CERTIFICATION & LICENSURE** + Registered Nurse - State Licensure - RN Required + Basic Life Support… more
- Alameda Health System (Oakland, CA)
- …such as PDCA, Lean, Six Sigma, and Statistical Process Control Analysis. 2 . Evaluates data, makes judgments, and recommendations regarding quality improvement work, ... systemwide Medical Staff quality and performance improvement activities such as Peer Review , OPPE, and FPPE as required by regulatory agencies. 10. Conduct in-depth… more
- Alameda Health System (San Leandro, CA)
- …in department meetings and operations, including process development or improvement. 2 . Assures clinical interventions are appropriate for the admitting diagnosis ... utilization and an appropriate level of care. 5. Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective … more
- Alameda Health System (Alameda, CA)
- …and other mandated regulations according to Department standards. Keeps required statistics. 2 . Reviews all the patients in his/her caseload in the following areas; ... Experience: One year related in acute care facility and/or utilization review training and/or healthcare experience. Minimum Experience: Varied clinical experience… more
- Alameda Health System (Oakland, CA)
- …information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services as ... by the care coordination nursing staff at all AHS acute care facilities. 2 . Communicates status with Utilization Management staff and arranges for patient transfer;… more
- Alameda Health System (Oakland, CA)
- …interactions with payors and communicates status with Care Management staff. 2 . Coordinates and obtains authorizations for admissions; documents all information in ... information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. 5.… more
- Alameda Health System (Alameda, CA)
- …is as outlined in the care plan and supported by documentation. 2 . Facilitates accurate determination of the Assessment Reference Date; Provides interdisciplinary ... a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited school of… more
- Alameda Health System (San Leandro, CA)
- …public; requests and provides information regarding program rules, regulations and activities. 2 . Compiles figures for the preparation of the unit's budget; makes ... Long Term Care requirements for patient length of stay, nurse :patient care time; and other required regulatory reports specific...interoffice and external mail; may plan, assign, direct and review the work of a small office support staff.… more