- Providence (Mission Hills, CA)
- **Description** The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management ... The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through...related area + Upon hire: California Registered Nurse License + 5 years Healthcare management … more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more… more
- Cedars-Sinai (Los Angeles, CA)
- …Motions, Eye/Hand/Foot Coordination **Req ID** : 1074 **Working Title** : Registered Nurse - Utilization Management - Per Diem Days **Department** : ... **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the... Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… 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. These ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient...record and in the required information system. + The RN CM reports to the Director/ Manager of… 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. These ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient...record and in the required information system. + The RN CM reports to the Director/ Manager of… more
- Select Medical (Los Angeles, CA)
- …Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
- Fresenius Medical Center (Los Angeles, CA)
- …the direction of the Facility Manager , Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other...the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II (After Hours Evening) Job Category: Clinical Department: Utilization Management Location: Los ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Dignity Health (Northridge, CA)
- … programs integrate. + Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required. + Minimum two (2) years ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Providence (Santa Monica, CA)
- …communication and care coordination along a continuum through effective transitional care management and utilization management . Recognizing the patient's ... be a condition of employment. + Upon hire: California Registered Nurse License + 2 years of...Post-Acute, etc.) + 2 years of experience in Case Management (Care Coordination or Utilization Management… more
- Providence (Mission Hills, CA)
- …Qualifications:** + Graduate of an accredited school of nursing. + upon hire: California Registered Nurse License. + 3 years of Clinical experience in an HMO, ... through effective resource coordination. The goal of the Care Manager is to advocate for and assist the patient...or Wound Care. + 3 years of experience in utilization management or case management .… more
- Cedars-Sinai (Marina Del Rey, CA)
- …Master's Degree in Nursing, Preferred **License/Certification:** + Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, ... hospital experience + ED Case Management experience, Strongly preferred **Working Title:** RN Case Manager , Emergency Dept - Full time, 12-hour, Night Shift… more
- Molina Healthcare (Los Angeles, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is preferred for this role. ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… 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
- Pipeline Health System, LLC (East Los Angeles, CA)
- …the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as ... Case Manager RN /LVN Per Diem 8 Hour...+ At least two (2) years' experience as a nurse in an acute care hospital. + At least...setting. + Consideration on a case-by-case basis for a RN without Case Management experience. + Critical… more
- Dignity Health (Northridge, CA)
- …Visit dignityhealth.org/northridgehospital for more information. **Northridge Hospital Medical Center** ** REGISTERED NURSE - Educator** **Operating Room** As an ... degree in Nursing or related field required. + Master's degree preferred + Registered Nurse with current California License required. + Current AHA BLS,… more
- UCLA Health (Santa Monica, CA)
- …+ 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
- Dignity Health (Los Angeles, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management ...five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN… more
- Elevance Health (Los Angeles, CA)
- …years acute care clinical experience is required. **Preferred Qualifications** + Previous utilization review/ utilization management experience in a managed ... Costa Mesa, Los Angeles, Rancho Cordova, Sacramento, Walnut Creek, Woodland Hills** The Nurse Medical Management I is responsible to collaborate with healthcare… more