- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189323/ case - manager 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
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189039/ case - manager -%28rn%29 utilization ... 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
- Dignity Health (Northridge, CA)
- …dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager (Care Coordinator) ... pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care....a clinical or insurance setting is required. + Certified Case Manager (CCM), Accredited Case … more
- ICW Group (Woodland Hills, CA)
- …evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical treatment and ... + Measures and reports on interventions to determine the outcome of the case manager 's involvement to include clinical, financial, variance, quality of life,… more
- Elevance Health (Cerritos, CA)
- …mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests involving radiology imaging ... clinical criteria and relevant Carelon Medical Benefits Management policies pertaining to utilization review . + Demonstrate and maintain knowledge of applicable… more
- Elevance Health (Cerritos, CA)
- …Health PulsePoint locations. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of high-tech diagnostic ... Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of diagnostic imaging procedures, cardiac services and… more
- Elevance Health (Placentia, CA)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or...more junior Clinicians. Approval decisions may be subject to review by more senior nurses or Medical Director. Primary… more
- Griffith Company (Los Angeles County, CA)
- …methods and sequence of operations. + Coordinate manpower and equipment utilization . + Assist project manager in conducting effective ... Review job costs and budget controls with project manager /foreman. + Monitor processing of timesheet and extra work...to candidates outside of the local area on a case -by- case basis. Visit us at: www.griffithcompany.net. Griffith… more
- Elevance Health (Cerritos, CA)
- …based guidelines, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of sleep studies, durable medical equipment, high-tech ... to work in a dynamic, fast-paced environment. + Preferred interest in Sleep management utilization review . For candidates working in person or remotely in the… more