- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools,...Eye/Hand/Foot Coordination **Req ID** : 1074 **Working Title** : Registered Nurse - Utilization Management… more
- Pipeline Health System, LLC (East Los Angeles, CA)
- Case Manager RN /LVN Per Diem 8 Hour...general supervision of the CM Director the nurse case manager manages clinical resource utilization and ... and documentation that affects reimbursement. In this position the case manager provides for a planned and...a general acute healthcare setting. + Consideration on a case -by- case basis for a RN … more
- Pipeline Health System, LLC (Gardena, CA)
- Case Manager Registered Nurse RN - Per Diem 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management...Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified Case… more
- Pipeline Health System, LLC (Huntington Park, CA)
- RN Case Manager - Registered Nurse Per Diem 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management...Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified Case… more
- Select Medical (Los Angeles, CA)
- …City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - ... discharge to home rate. **Benefits of working as a Case Manager with us:** + Excellent Orientation...Current licensure in a clinical discipline per state guidelines ( RN , LCSW preferred). + Previous experience in Case… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Admissions Liaison RN II...California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case … more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Utilization Management RN Job Category: Clinical...The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols,… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Dignity Health (Northridge, CA)
- …centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager ... Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required....Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM… more
- UCLA Health (Los Angeles, CA)
- …regulations + Ability to travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,… more
- Cedars-Sinai (Marina Del Rey, CA)
- …+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience** : + Minimum of two ... with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services),...Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review. + Reviews care and treatment for appropriateness… more
- Providence (Orange, CA)
- **Description** **Care Manager RN at St Joseph Hospital-Orange in Orange, CA. Positions available are either Full Time or Per Diem, Day shifts.** Care Management ... Graduate of an accredited school of nursing. + California Registered Nurse License upon hire. + 3...Wound Care upon hire. + 3 years Experience in utilization management or case management. **Why Join… 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 ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_PERMANENT SHIFT WILL BE :_** **_12 hour...in the USA if they have a valid CALIFORNIA RN license must work the shift hours as posted.… more
- Amergis (Orange, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... assessments and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart review/audits monthly… more
- UCLA Health (Los Angeles, CA)
- …staff) + CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years ... safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care.… more
- Emanate Health (West Covina, CA)
- …nurses new to the US healthcare system must satisfactorily complete the Emanate Health RN Residency Program within the first 6 months of employment. Two years recent ... acute clinical experience. Experience with discharge planning, utilization management and critical pathways preferred. Effective written, verbal and time management… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Required: Knowledge of state, federal and regulatory requirements in Appeals/Care/ Case / Utilization Management/Quality. Strong verbal and written communication… more
- Dignity Health (Long Beach, CA)
- …(5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM- RN ) or UM Certification preferred + Knowledge of managed ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Case Manager II** **Location** : Woodland Hills, CA; Costa Mesa, CA; Palo Alto, CA & Walnut Creek, CA. This position will work a hybrid model (remote ... of our Elevance Health PulsePoint locations listed above. The ** Nurse Case Manager II** will...+ Bilingual preferred. + Discharged planning experience preferred. + Utilization Management experience preferred. + Case Management… more