- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for… 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 ... Nursing Experience Required: At least 5 years of varied clinical experience in an acute hospital setting. At least...Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management … more
- Dignity Health (Northridge, CA)
- …acute hospital setting required. + Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or insurance setting ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… more
- Cedars-Sinai (Los Angeles, CA)
- …of continued employment. **Req ID** : 4870 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem **Department** : Utilization ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We were also...Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to… more
- UCLA Health (Los Angeles, CA)
- …leader with: + Current CA LVN licensure required + Two or more years of utilization review/ utilization management experience in an HMO, MSO, IPA, or health ... Health. You will play a key part in promoting high- quality , cost-effective medical care by applying clinical ...promoting high- quality , cost-effective medical care by applying clinical acumen and applicable policies and guidelines in the… more
- Prime Healthcare (Anaheim, CA)
- …Responsibilities Responsible for the quality and resource management ... of care. The methodology is designed to facilitate and insure the achievement of quality , clinical and cost effective outcomes and to perform a holistic and… more
- Prime Healthcare (Lynwood, CA)
- …Responsibilities Responsible for the quality and resource management ... admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost...is designed to facilitate and insure the achievement of quality , clinical and cost effective outcomes and… more
- Prime Healthcare (Lynwood, CA)
- …Responsibilities Responsible for the quality and resource management ... admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost...is designed to facilitate and insure the achievement of quality , clinical and cost effective outcomes and… more
- UCLA Health (Los Angeles, CA)
- …Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff ... and key performance indicators. You will hire and train non- clinical coordinator staff as well as manage and monitor...as well as manage and monitor their production and quality performance. This position involves researching and resolving simple… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
- Fresenius Medical Center (Irwindale, CA)
- …and attends QAPI meetings at a frequency determined by Clinical Quality leadership. Collaborates with facility management staff to evaluate the effectiveness ... and performance improvement activities which positively influence the assigned dialysis clinics clinical quality outcomes. The scope of the clinical … more
- LA Care Health Plan (Los Angeles, CA)
- … and staff. Prepares reports for the Delegation Oversight Committees, Quality Committees, Utilization Management Committees, Sanctions Committees, ... collaboratively with other LA Care departments to improve Service Quality and Clinical Quality provided...with a focus in areas of Utilization Management , Care Management , Quality Improvement… more
- LA Care Health Plan (Los Angeles, CA)
- …programs, including clinical initiatives that impact drug utilization , clinical education and staff development, management of appropriate drug ... utilization , drug spend analysis, and quality improvement activities related to pharmaceuticals. This position will assist in the oversight of daily operations of… more
- Molina Healthcare (Long Beach, CA)
- …+ Minimum 3 years Managed Care experience + Minimum 3 years Utilization Management Review experience **Required Licensure or Certification:** Active, ... (RN) License in good standing **Preferred Qualifications:** + 5+ years of experience in Utilization Management in Managed Care setting + 5+ years of clinical… more
- Abbott (Los Angeles, CA)
- …of the clinical team. Responsible for the development / coaching of clinical representatives, as well as administrative management tasks. + Partner with ... Coordinate, develop, and implement strategies to increase service efficiency and optimize clinical headcount utilization . Leverage best practices via network of … more
- Cedars-Sinai (Culver City, CA)
- …as liaison, for administrative support activities including facilities management , pharmacy, utilization management , quality management , risk ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We were also...guidelines. 7. Works in a collaborative role with the management team, staff and physicians in the clinical… more
- Cedars-Sinai (Los Angeles, CA)
- …engages finance to ensure adequate financial performance, effective expense reduction, utilization management , budget control and new revenue generation. ... Clinical Operations will be responsible for the overall management and leadership in the delivery of comprehensive, high... and leadership in the delivery of comprehensive, high quality services within the assigned area. The Director, in… more
- The County of Los Angeles (Los Angeles, CA)
- CLINICAL NURSING DIRECTOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3136407) Apply CLINICAL NURSING DIRECTOR I Salary $147,753.60 ... PLAN (MAPP) : This position is subject to the provisions of the Management Appraisal of Performance Plan (MAPP). Initial salary placement and subsequent salary… more
- Cedars-Sinai (Los Angeles, CA)
- …the delivery of patient care and ensures optimal levels and continuous improvement of clinical and service quality within the unit for all service line ... heart muscle function and heart valve dysfunction. As the Manager, of Clinical Operations for the Cardiovascular Intervention Center, you will ensure daily… more