- Elevance Health (Costa Mesa, CA)
- …years acute care clinical experience is required. **Preferred Qualifications** + Previous utilization review/ utilization management experience in a managed ... Costa Mesa, Los Angeles, Rancho Cordova, Sacramento, Walnut Creek, Woodland Hills** The Nurse Medical Management I is responsible to collaborate with healthcare… 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. These include ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient progression, and… more
- Molina Healthcare (Long Beach, CA)
- **_JOB TITLE: RN ( REGISTERED NURSE ) Program...years in one or more of the following areas: utilization management , case management , care ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN… 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. These include ... utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient progression, and… more
- Fresenius Medical Center (Garden Grove, CA)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... **POSITION FEATURES:** This is a full time RN role for our Garden Grove, CA surgery...adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other… more
- Dignity Health (Northridge, CA)
- … programs integrate. + Knowledge of CMS standards and requirements. **Qualifications** + CA Registered Nurse ( RN ) License required. + Minimum two (2) years ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Molina Healthcare (Santa Ana, CA)
- …we are seeking a Nurse with previous experience in Prior Auth Utilization Management and knowledge of Interqual or MCG guidelines. CALIFORNIA LICENSURE IS ... **JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN)… more
- Dignity Health (Northridge, CA)
- …Visit dignityhealth.org/northridgehospital for more information. **Northridge Hospital Medical Center** ** REGISTERED NURSE - Educator** **Operating Room** As an ... degree in Nursing or related field required. + Master's degree preferred + Registered Nurse with current California License required. + Current AHA BLS,… more
- Providence (Orange, CA)
- …+ Coursework/Training: Graduate of an accredited school of nursing. + California Registered Nurse License upon hire. + 3 years Clinical experience ... **Description** **Care Manager RN at St Joseph Hospital-Orange in Orange, CA....Wound Care upon hire. + 3 years Experience in utilization management or case management .… more
- Molina Healthcare (Long Beach, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is preferred for this role. ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Cedars-Sinai (Tarzana, CA)
- …assigned unit. + Responsible for administrative support activities involving facilities management , pharmacy, utilization management , quality management ... **Job Description** The Supervisor, Clinical Operations Oncology RN is responsible for supervising the clinical staff and clinical operations of the Oncology… more
- Pipeline Health System, LLC (East Los Angeles, CA)
- …Hour Day Shift Under the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting ... + At least two (2) years' experience as a nurse in an acute care hospital. + At least...setting. + Consideration on a case-by-case basis for a RN without Case Management experience. + Critical… more
- Elevance Health (Costa Mesa, CA)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to...and initiatives. **Minimum Requirements:** Requires current active valid unrestricted RN license to practice as a health professional in… more
- Amergis (Orange, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service delivery, ... referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care… more
- Elevance Health (Costa Mesa, CA)
- …experience preferred + Bilingual preferred. + Discharged planning experience preferred. + Utilization Management experience preferred. + Case Management ... ** Nurse Case Manager II** **Location** : Woodland Hills,...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Providence (Fullerton, CA)
- …a member of the surgical team, under the direct supervision of the Registered Nurse Circulator, maintains the operating room sterile field; passes instruments, ... is utilized to prevent contamination and infection. Assists the registered nurse with circulating duties. Providence caregivers...Degree Related Field + 3 years of Experience in utilization management or case management .… more
- Molina Healthcare (Long Beach, CA)
- …to be successful for this role. Training skills helpful. Knowledge of Utilization Management processes, EMR systems and Health Information Exchange very ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...years in one or more of the following areas: utilization management , case management , care… more
- Providence (Orange, CA)
- …degree, clinical degree is preferred (MD, RN , DO) + Upon hire: California Registered Nurse License (preferred) + 7 years of experience Clinical Leadership + ... **QUALIFICATIONS** + Master's Degree in Nursing, Public Health, Business Administration, Medical Management , or a related field; or MD or, DO; or equivalent… more
- Fresenius Medical Center (Long Beach, CA)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more