• Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the… more
    LA Care Health Plan (07/03/24)
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  • Supervisor, Utilization Management

    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: ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for… more
    LA Care Health Plan (08/07/24)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... Nursing Experience Required: At least 5 years of varied clinical experience in an acute hospital setting. At least...Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management more
    LA Care Health Plan (09/11/24)
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  • RN Utilization Management

    Dignity Health (Northridge, CA)
    …acute hospital setting required. + Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or insurance setting ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… more
    Dignity Health (08/29/24)
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  • Registered Nurse - Utilization

    Cedars-Sinai (Los Angeles, CA)
    …of continued employment. **Req ID** : 4870 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem **Department** : Utilization ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We were also...Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to… more
    Cedars-Sinai (08/29/24)
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  • Utilization Management Denial Review…

    UCLA Health (Los Angeles, CA)
    …leader with: + Current CA LVN licensure required + Two or more years of utilization review/ utilization management experience in an HMO, MSO, IPA, or health ... Health. You will play a key part in promoting high- quality , cost-effective medical care by applying clinical ...promoting high- quality , cost-effective medical care by applying clinical acumen and applicable policies and guidelines in the… more
    UCLA Health (06/25/24)
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  • RN Utilization Management - Remote

    Amergis (Los Angeles, CA)
    …Promotes an awareness of the importance of data validity and security + Performs quality assurance checks of documentation workflows and clinical data in the ... Amergis Healthcare Staffing is seeking a Quality Improvement Coordinator responsible for analyzing, developing, monitoring and implementing clinical initiatives… more
    Amergis (09/11/24)
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  • Case Manager, RN - Utilization Review

    Prime Healthcare (Lynwood, CA)
    …Responsibilities Responsible for the quality and resource management ... admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost...is designed to facilitate and insure the achievement of quality , clinical and cost effective outcomes and… more
    Prime Healthcare (08/23/24)
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  • Utilization Management Supervisor

    UCLA Health (Los Angeles, CA)
    …Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff ... and key performance indicators. You will hire and train non- clinical coordinator staff as well as manage and monitor...as well as manage and monitor their production and quality performance. This position involves researching and resolving simple… more
    UCLA Health (08/28/24)
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  • Enhanced Care Management Clinical

    LA Care Health Plan (Los Angeles, CA)
    Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
    LA Care Health Plan (08/20/24)
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  • Delegation Oversight Clinical Auditor RN II

    LA Care Health Plan (Los Angeles, CA)
    Clinical Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf of LA Care (LAC) is in ... also acts as a liaison between the Plan Partners, PPGs and Vendors regarding Utilization Management (UM) issues; assists in improving access and utilization more
    LA Care Health Plan (09/11/24)
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  • Clinical Pharmacist II

    LA Care Health Plan (Los Angeles, CA)
    …programs, including clinical initiatives that impact drug utilization , clinical education and staff development, management of appropriate drug ... utilization , drug spend analysis, and quality improvement activities related to pharmaceuticals. This position will assist in the oversight of daily operations of… more
    LA Care Health Plan (09/07/24)
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  • Clinical Sales Manager, CPT -California,…

    Abbott (Los Angeles, CA)
    …of the clinical team. Responsible for the development / coaching of clinical representatives, as well as administrative management tasks. + Partner with ... Coordinate, develop, and implement strategies to increase service efficiency and optimize clinical headcount utilization . Leverage best practices via network of … more
    Abbott (06/20/24)
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  • Clinical Operations Supervisor, LVN

    Cedars-Sinai (Culver City, CA)
    …as liaison, for administrative support activities including facilities management , pharmacy, utilization management , quality management , risk ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We were also...guidelines. 7. Works in a collaborative role with the management team, staff and physicians in the clinical more
    Cedars-Sinai (07/14/24)
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  • Clinical Nursing Director I

    The County of Los Angeles (Los Angeles, CA)
    CLINICAL NURSING DIRECTOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3136407) Apply  CLINICAL NURSING DIRECTOR I Salary $147,753.60 ... PLAN (MAPP) : This position is subject to the provisions of the Management Appraisal of Performance Plan (MAPP). Initial salary placement and subsequent salary… more
    The County of Los Angeles (07/01/24)
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  • Mgr, Clinical Operations. Cath Lab

    Cedars-Sinai (Los Angeles, CA)
    …the delivery of patient care and ensures optimal levels and continuous improvement of clinical and service quality within the unit for all service line ... heart muscle function and heart valve dysfunction. As the Manager, of Clinical Operations for the Cardiovascular Intervention Center, you will ensure daily… more
    Cedars-Sinai (07/25/24)
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  • Field Clinical Specialist, Los Angeles…

    Edwards Lifesciences (Los Angeles, CA)
    …Regional Director and will collaborate with multiple departments including Sales, Clinical Affairs, Marketing, Quality , Regulatory, and Education. After ... , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing...educational material during training sessions in order to drive utilization of the Edwards's THV product portfolio. + Utilizing… more
    Edwards Lifesciences (06/20/24)
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  • Clinical Value Nurse Practitioner (NP)…

    Cedars-Sinai (Beverly Hills, CA)
    …responsible for clinical programs designed to make clinical quality , safety, or efficiency improvements. (preferred) **Educational/Licensure/Certifications ... **Job Description** **What will you be doing:** The Clinical Value Coordinator (Nurse Practitioner) is responsible for...performance - all while maintaining or improving the overall quality of care delivered. + Leads implementation of departmental… more
    Cedars-Sinai (06/22/24)
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  • Clinical Value Physician Assistant (PA-C)…

    Cedars-Sinai (Beverly Hills, CA)
    **Job Description** **What will you be doing:** The Clinical Value Coordinator (Physician Assistant) is responsible for supporting collaborative efforts focused on ... in an assigned department(s). The CVPL works with the Clinical Efficiency & Value team, the home department, and...performance - all while maintaining or improving the overall quality of care delivered. + Leads implementation of departmental… more
    Cedars-Sinai (06/22/24)
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  • Clinical Patient Access Rep - Patient…

    Cedars-Sinai (Los Angeles, CA)
    …Coordinates administrative support activities including facilities management , patient billing, utilization management , quality management , and risk ... people every single day? Are you passionate about providing outstanding and high- quality service to patients and their family members?** **Join our world-class… more
    Cedars-Sinai (08/08/24)
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