- Blue Shield of California (Los Angeles, CA)
- …RN License. Bachelors of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in process of completing certification ... wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this… more
- Blue Shield of California (Long Beach, CA)
- …RN License. Bachelors of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in process of completing certification ... and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of...community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating… 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
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be ... follows the UR process as defined in the Utilization Review Plan in accordance with the...continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager -… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management, Assistant Manager , you will play a key role in processing and ... vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...in an acute hospital setting. At least 2 years Utilization Management/ Case Management experience in a hospital… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Utilization Management Representative II **Job Description:** ** Utilization Management Representative ... Palo Alto, Walnut Creek, Rancho Cordova and Sacramento, CA.** The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Pipeline Health System, LLC (Huntington Park, CA)
- The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and ... 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 (Gardena, CA)
- …hospitals to available beds in our hospitals for quality care. Job Summary: The RN Case Manager (CM) performs a wide variety of tasks and functions. These ... include utilization review , discharge planning, care coordination and...Nursing + Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified… more
- Prime Healthcare (Inglewood, CA)
- …Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators ... Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The working Manager of Case Management is responsible… more
- Cedars-Sinai (Marina Del Rey, CA)
- …our community with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services), you will be responsible for the coordination ... Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review . + Reviews care and treatment...+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience**… more
- Amergis (Torrance, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart... information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly… more
- UCLA Health (Los Angeles, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... + CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years of acute… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Certified Professional ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...Prepares reports for the Delegation Oversight Committees, Quality Committees, Utilization Management Committees, Sanctions Committees, Internal Compliance Committees, etc.… 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
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + 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
- Amity Foundation (Los Angeles, CA)
- …issues, technological challenges, and/or child support payments. + May liaise with existing Case Manager or referral partner to ensure a warm hand-off into ... and supports for project participants. This position liaises with existing Case Managers (referral partners), educational partners and prospective employers to… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …HBPC policies and procedures to include performance improvement, patient safety, utilization review , emergency preparedness, and staff safety. Responsible for ... activities and providing follow-up actions required by internal and external review organizations and or accrediting bodies. Responsible for communicating and… more
