- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/ rn - case - manager ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five… more
- Providence (Irvine, CA)
- **Description** ** RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, retrospective, ... Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience...remote UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree… more
- University of Southern California (Alhambra, CA)
- …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an… more
- University of Southern California (Arcadia, CA)
- …and maintain BLS certification. Preferred (Not required) Professional certification as a case manager preferred. Pay Transparency The hourly rate range for ... the compilation of physician profile data regarding LOS, resource utilization , denied days, cost, case mix index,.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
- Elevance Health (Costa Mesa, CA)
- **Telephonic Nurse Case Manager II** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of ... members in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management… more
- University of Southern California (Arcadia, CA)
- …Education: Bachelors Degree Nursing Minimum Skills: Possess basic computer skills. Required Certifications: Registered Nurse - RN (CA Board of Registered ... patient care interactions.* Performs other duties as assigned by Manager / Director / Clinical Lead RN .*...RN experience in assigned area of Nursing. A registered nurse with current RN … more
- Providence (Fullerton, CA)
- …Qualifications:** + Graduate of an accredited school of nursing. + Upon hire: California Registered Nurse License + 3 years clinical experience in an HMO, ... Transplant, or Wound Care + 3 years experience in utilization management or case management. **Why Join Providence?** Our best-in-class benefits are uniquely… more
- Dignity Health (Long Beach, 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
- 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate.… more
- Elevance Health (Costa Mesa, CA)
- …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... **Behavioral Health - Care Manager II** **Location:** _Virtual:_ This role enables associate...appropriate. + Performs psychiatric and autism assessment coordination implementation case planning monitoring and evaluating to promote quality member… more
- Elevance Health (Costa Mesa, CA)
- **JR177558 Behavioral Health Care Manager I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
- University of Southern California (Arcadia, CA)
- …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review/ case management in an ... physicians, associates, and adheres to HIPAA regulations. Keep the CDI team and HIM Manager or Director informed of workflow status and potential backlog issues. more