- Dignity Health (Woodland, CA)
- …Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level ... - Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review prior authorizations for medical determination, preferred. - Bachelors… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/227408/ registered - nurse %2c- rn… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/224065/ registered - nurse %2c- rn… more
- Cognizant (Sacramento, CA)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Cedars-Sinai (Beverly Hills, CA)
- …assessing their needs, coordinating care, communicating with health plans (including concurrent review , which assists the hospitalist/specialist and case manager ... of previous experience in case management, discharge planning, utilization review , and HMO in the acute inpatient ...ID** : 12522 **Working Title** : Lead Case Manager RN - Inpatient Specialty Program - 8-Hour… more
- Cedars-Sinai (Beverly Hills, CA)
- …by assessing their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered ... of care and level of care. Use evidence based review guidelines to conduct utilization review as...for Hiring. **Req ID** : 12511 **Working Title** : RN Care Coordinator - Inpatient Specialty Program… 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 ... equipment, and other discharge needs. Provides support to the inpatient review team as necessary to ensure...to, placement (with level of care) criteria (MCG, InterQual), concurrent review , and discharge planning. Preferred: Consistent… more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...information to the department head as indicated. + Utilization review and utilization managementThe RN CM I… more
- Dignity Health (Folsom, CA)
- …including mock survey tracers. **Job Requirements** **Minimum Required** + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). + Participates in an integral… more