- Molina Healthcare (San Diego, CA)
- …Management / Utilization Review is required for this role. Experience with Case Management is a plus._** **_This is a remote role (work from home). Excellent ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12...illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost… more
- Sharp HealthCare (San Diego, CA)
- …sees every patient identified per departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the ... acute patient care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience… more
- Sharp HealthCare (San Diego, CA)
- …by themselves, Medical Directors, the Hospitalist Physician and/or Hospitalist Case Manager (HCM).Identifies and refer requests for review by higher level ... provide, support, and help facilitate care coordination services provided by the Hospitalist Case Manager . This position is responsible for the care and services… more
- Sharp HealthCare (San Diego, CA)
- …Start Time** **Shift End Time** Bachelor's Degree in Nursing; Master's Degree; Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for ...or case management experience. + 3 Years case management, utilization review , care coordination experience.… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Case Manager (CCM) - Commission for Case Manager Certification; Bachelor's Degree in Nursing;...and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. This position… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …discharge needs, and providing information to the Quality department for follow-up. The Case Manager advocates for the patient and family and collaborates with ... of computers PREFERRED QUALIFICATIONS: Four years of experience Utilization review , case management, discharge planning experience Bilingual English/Spanish… more
- Sharp HealthCare (San Diego, CA)
- …On site staff for follow up on unfunded patients.Screens all Medicare inpatient admissions for 72-hour outpatient overlap.72-hour outpatient overlaps are used for ... Medicare inpatient admits.Complies with all rules and regulations governing Medicare...professionally with the on-call physicians, Emergency room physicians and Case Managers when appropriateMEASUREMENT: No more than 2-3 valid… more
- Insight Global (San Diego, CA)
- …and implementation of the interdisciplinary plan of care. JOB RESPONSIBILITIES a. Case Management and Supervision for Registered Nurse, RN 1. Registered Nurse, RN, ... to practice outside of scope of license to the manager /supervisor 3. Registered Nurse, RN, performs supervision of (VITAS...plan of care. i. Provides primary nursing care for inpatient and continuous care patients as assigned. b. Quality… more