- Blue Shield of California (Los Angeles, CA)
- …care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities ... outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population...of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in… more
- Blue Shield of California (Long Beach, CA)
- …care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities ... Senior Care Manager will report to the Manager of Care Management . In this role...of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or is in… more
- Cedars-Sinai (Los Angeles, CA)
- …annually thereafter as a condition of continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager - 8 Hour Days Per ... Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates...required. **Experience:** + Minimum of 2 years experience in Case Management preferred + Minimum of 3… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ case - manager %2c-rn utilization ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … 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 ... a vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the… 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 ... (BSN) degree required + Five or more years of utilization management required + Four or more...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- LA Care Health Plan (Los Angeles, CA)
- …years of varied clinical experience in an acute hospital setting. At least 2 years Utilization Management / Case Management experience in a hospital or HMO ... Utilization Management Nurse Specialist RN II...Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Utilization Management Representative II **Job Description:** ** Utilization Management ... Alto, Walnut Creek, Rancho Cordova and Sacramento, CA.** The ** Utilization Management Representative II** is responsible for...of community resources and social determinants of health. + Case management experience. + For URAC accredited… more
- Prime Healthcare (Inglewood, CA)
- …Responsibilities The working Manager of Case ... Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators… more
- Pipeline Health System, LLC (Huntington Park, CA)
- The RN Case Manager (CM) performs a wide...and wise utilization of resources. + Documents case management activities in the patient record ... prepared a plus. + Minimum of 2-3 years in Case Management Acute Care setting Licensure/Certifications: +...Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified Case… more
- Pipeline Health System, LLC (Gardena, CA)
- …coordination of patient care and wise utilization of resources. + Documents case management activities in the patient record and in the required information ... our hospitals for quality care. Job Summary: The RN Case Manager (CM) performs a wide variety...utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient… more
- Cedars-Sinai (Marina Del Rey, CA)
- …+ ED Case Management experience, Strongly preferred **Working Title:** RN Case Manager , Emergency Dept - Per Diem, 12-hour Night Shift - Marina del ... the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services), you will be...will be responsible for the coordination and implementation of case management strategies pursuant to the … more
- Amergis (Torrance, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making...in state practicing + At least one year of Case Management experience preferred + Complies with… more
- UCLA Health (Los Angeles, CA)
- …Health Nursing staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + ... 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
- LA Care Health Plan (Los Angeles, CA)
- …in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: ... current and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager … more
- Providence (Torrance, CA)
- …in Healthcare related field (Acute, Ambulatory, Post-Acute, etc.) + 2 years experience in Case Management (Care Coordination or Utilization Management ) ... **Description** Case Management is a collaborative practice...achievement of optimal health, access to services, advocacy, appropriate utilization of resources and collaboration with post-acute care providers… more
- Providence (Santa Monica, CA)
- …Healthcare related field (Acute, Ambulatory, Post-Acute, etc.) + 2 years of experience in Case Management (Care Coordination or Utilization Management ) ... Care Management Team at Providence Saint Johns! Case Management is a collaborative practice including...care coordination along a continuum through effective transitional care management and utilization management . Recognizing… more
- UCLA Health (Los Angeles, CA)
- …+ Current unrestricted California RN license. + BSN Degree + 5 years of Case Management experience + Must have strong problem solving skills; ability to ... quality outcomes by effectively managing care and resources to reduce unnecessary utilization . The RN Care Manager utilizes clinical expertise and understanding… more
- LA Care Health Plan (Los Angeles, CA)
- …Practitioner (NP)- Active, current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) ... Prepares reports for the Delegation Oversight Committees, Quality Committees, Utilization Management Committees, Sanctions Committees, Internal Compliance… more