- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ case - manager %2c-rn 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
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be ... follows the UR process as defined in the Utilization Review Plan in accordance with the...continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager -… 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 and ... vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...in an acute hospital setting. At least 2 years Utilization Management/ Case Management experience in a hospital… more
- Pipeline Health System, LLC (Gardena, CA)
- RN Case Manager Full Time 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization ... 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 (East Los Angeles, CA)
- The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and ... 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
- Elevance Health (Los Angeles, CA)
- ** Utilization Management Representative II** **Location** : This is a remote position. Candidates must live in the state of **California** . Seeking candidates that ... Palo Alto, Walnut Creek, Rancho Cordova and Sacramento, CA.** The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Prime Healthcare (Inglewood, CA)
- …Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators ... Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The working Manager of Case Management is responsible… more
- Cedars-Sinai (Marina Del Rey, CA)
- …our community with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services), you will be responsible for the coordination ... Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review . + Reviews care and treatment...+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience**… more
- Amergis (Torrance, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart... information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly… more
- UCLA Health (Los Angeles, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... + CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years of acute… more
- Dignity Health (Northridge, CA)
- …(https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Care Coordinator Case Manager Northridge Hospital Medical Center ... pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care....Nursing (BSN)) or related healthcare field. preferred + Certified Case Manager (CCM), Accredited Case … more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Amity Foundation (Los Angeles, CA)
- …issues, technological challenges, and/or child support payments. + May liaise with existing Case Manager or referral partner to ensure a warm hand-off into ... and supports for project participants. This position liaises with existing Case Managers (referral partners), educational partners and prospective employers to… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …HBPC policies and procedures to include performance improvement, patient safety, utilization review , emergency preparedness, and staff safety. Responsible for ... activities and providing follow-up actions required by internal and external review organizations and or accrediting bodies. Responsible for communicating and… more
- The County of Los Angeles (Los Angeles, CA)
- …to a line operation responsible for the delivery of psychological rehabilitation, case management and/or Psychiatric Emergency Service of the Department of Mental ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- Elevance Health (Los Angeles, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more
- The County of Los Angeles (Los Angeles, CA)
- …assigned to a line operation responsible for delivering psychological rehabilitation, case management, and/or psychiatric emergency services in the Department of ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more