- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools,...Eye/Hand/Foot Coordination **Req ID** : 1074 **Working Title** : Registered Nurse - Utilization Management… more
- Pipeline Health System, LLC (East Los Angeles, CA)
- Case Manager RN /LVN Per Diem 8 Hour...general supervision of the CM Director the nurse case manager manages clinical resource utilization and ... and documentation that affects reimbursement. In this position the case manager provides for a planned and...a general acute healthcare setting. + Consideration on a case -by- case basis for a RN … 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. ... 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 (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. ... 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
- Select Medical (Los Angeles, CA)
- …City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - ... discharge to home rate. **Benefits of working as a Case Manager with us:** + Excellent Orientation...Current licensure in a clinical discipline per state guidelines ( RN , LCSW preferred). + Previous experience in Case… more
- Providence (Mission Hills, CA)
- …+ Bachelor's Degree in Nursing or other related area + Upon hire: California Registered Nurse License + 5 years Healthcare management experience related to acute ... **Description** The Manager of Utilization Management provides a...a remote UR team + Previous experience as a case manager in an acute care setting… 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 ... Supervisor, Utilization Management RN Job Category: Clinical...The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols,… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Dignity Health (Northridge, CA)
- …centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager ... Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required....Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM… more
- UCLA Health (Los Angeles, CA)
- …regulations + Ability to travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,… more
- Providence (Mission Hills, CA)
- …must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working ... in a remote UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree in Nursing. + Master's Degree in… more
- Providence (Santa Monica, CA)
- …we must empower them. Providence is calling for applications for our **February 2025 RN Case Manager Fellowship at Providence Saint John's Health Center.** ... be a condition of employment. + Upon hire: California Registered Nurse License. + 2 years experience...(Acute, Ambulatory, Post-Acute, etc.) + 2 years experience in Case Management (Care Coordination or Utilization Management)… more
- Cedars-Sinai (Marina Del Rey, CA)
- …+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience** : + Minimum of two ... with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services),...Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review. + Reviews care and treatment for appropriateness… more
- Molina Healthcare (Los Angeles, CA)
- …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_PERMANENT SHIFT WILL BE :_** **_12 hour...in the USA if they have a valid CALIFORNIA RN license must work the shift hours as posted.… more
- UCLA Health (Los Angeles, CA)
- …staff) + 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
- Providence (Santa Monica, CA)
- …obtaining the degree will not be a condition of employment. + Upon hire: California Registered Nurse License + 2 years of experience in Healthcare related field ... Degree in Nursing or Healthcare related field. + A RN with 20 years of RN experience...Ambulatory, 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. **Why Join… 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
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Case Manager II** **Location** : Woodland Hills, CA; Costa Mesa, CA; Palo Alto, CA & Walnut Creek, CA. Elevance Health supports a hybrid workplace ... 50 miles of the PulsePoint sites listed above. The ** Nurse Case Manager II** will...+ Bilingual preferred. + Discharged planning experience preferred. + Utilization Management experience preferred. + Case Management… more