- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/173003/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (Anaheim, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/170050/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...related field or at least one year experience in case management, discharge planning or nursing management; + CCM… more
- Molina Healthcare (Long Beach, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is required for this role. ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees:… more
- Providence (Mission Viejo, CA)
- **Description** Under the direction of the Utilization Supervisor/ Manager , this position is responsible for the distribution, review , accurate and timely ... Assistant Certification (CMA) + 1 year of experience in utilization management or case management with experience in medical terminology and coding. **Why… more
- Molina Healthcare (Long Beach, CA)
- …are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge ... **_JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees:… more
- HCA Healthcare (Riverside, CA)
- …you will need:** + Registered Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + ... be a part of what makes us great and apply today! The RN Case Manager facilitates the progression and transition of care using established criteria and in… more
- Elevance Health (Cerritos, CA)
- …services only, and there is licensed staff supervision.** + Previous experience in case management/ utilization management with a broad range of experience with ... for outpatient professional treatment health benefits through telephonic or written review .** **This role Requires a BCBA ( Board Certified Behavioral Analyst… more
- Dignity Health (Northridge, CA)
- …(https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Care Coordinator Case Manager Northridge Hospital Medical Center ... pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care....Nursing (BSN)) or related healthcare field. preferred + Certified Case Manager (CCM), Accredited Case … 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 ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Molina Healthcare (Long Beach, CA)
- …/ LPN) Nurse with previous experience in Case management, Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of ... + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT),… more
- Illumination Foundation (Orange, CA)
- …Health Information (PHI) into various Health Network Portals and KIPU. + Upon referral review , note all questions that may need to be answered by referral contact in ... an examination of deficits in documentation. Deficits in this case are measured against internal and external (contracted) demands,...to parallel the act of auditing insofar as the manager / lead is incumbent to enforce and address… more