• RN Inpatient Review Case

    Molina Healthcare (Riverside, 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
    Molina Healthcare (08/11/24)
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  • RN Care Coordinator

    Dignity Health (Northridge, CA)
    …(https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Care Coordinator Case Manager Northridge Hospital Medical Center ... nursing (Bachelor's Degree in Nursing (BSN)) or related healthcare field. preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
    Dignity Health (07/17/24)
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  • Utilization Management Representative II

    Elevance Health (Woodland Hills, CA)
    …+ Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service ... referrals given. + Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests… more
    Elevance Health (09/06/24)
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