- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality - related job preferred.… more
- LA Care Health Plan (Los Angeles, CA)
- …verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or ... Utilization Management Admissions Liaison RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- LA Care Health Plan (Los Angeles, CA)
- …verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or ... Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Ventura County (Ventura, CA)
- …Health Care Agency - Ventura County Medical Center/ Santa Paula Hospital APPROXIMATE SALARIES: Registered Nurse II ( RN II): $51.30 - $61.35 per hour ... Registered Nurse II - Emergency Department...care as indicated and required. + May participate in quality assurance / utilization review or other… more
- Ventura County (Ventura, CA)
- …attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... Medical Surgical and Telemetry Registered Nurse II - Float Pool -Regular and Per Diem Print… more
- Ventura County (Ventura, CA)
- …attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... Registered Nurse II - Medical Surgical and Detox Department (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4920936)… more
- Ventura County (Ventura, CA)
- …assistance and patient care as indicated and required. + May participate in quality assurance / utilization review or other non-direct patient care nursing ... Registered Nurse II - ICU/DOU/Telemetry (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4887199) Apply Registered … more
- Ventura County (Ventura, CA)
- …attends department in-services and staff development programs; + May participate in quality assurance / utilization review or other non-direct patient care ... Registered Nurse II - Pre-op/PACU Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4914734) Apply Registered Nurse II - Pre-op/PACU… more
- Ventura County (Ventura, CA)
- …and performance improvement in designated hospital units of Ventura County Medical Center. Quality Assurance and Performance Improvement Nurse : The incumbent ... Senior Registered Nurse - QAPI Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4925952)...will support and facilitate quality assurance and performance improvement initiatives aimed at enhancing patient… more
- Ventura County (Ventura, CA)
- …x-rays and medications, maintains records and prepares reports; + May participate in quality assurance / utilization review or other non-direct patient care ... Pediatrics Intensive Care Unit (PICU), or Pediatrics (Peds). The registered nurse performs the full range of...and contribute to the hospital's mission of delivering inclusive, high- quality care to women, infants, and children. WHAT WE… more
- Amergis (Santa Rosa, CA)
- …entitlements, resources, information, and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed ... Salary: $3301 / Week The RN Case Manager is responsible for coordinating continuum...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… more
- Ventura County (Ventura, CA)
- …measures; Attends department in-services and staff development programs; May participate in quality assurance / utilization review or other non-direct patient ... CANDIDATE The ideal candidate is a compassionate, adaptable, and clinically skilled registered nurse who excels in delivering comprehensive care to patients… more
- Sharp HealthCare (San Diego, CA)
- …Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse ( RN ) - CA Board of Registered ... RN experience in related clinic area. + California Registered Nurse ( RN ) - CA...pass testing on second attempt = Needs Improvement. + Quality initiativesCompletes Quality Assurance assignments… more
- The Cigna Group (Sacramento, CA)
- …requirements:** **Ideal Candidate must reside in California** + Current active unrestricted California Registered Nurse . Must have ( RN ) license in state ... courteously and according to Policy and Procedure, Case Management Standards, and Quality Assurance standards. + Manages annual and semi-annual performance… more
- CommonSpirit Health (Rancho Cordova, CA)
- …within the organization to expedite this process. Primary responsibility for completing quality assurance reviews of work performed and communicating with ... **Responsibilities** ICU RN , Emergency Room RN or Level...**Core Duties:** + Compiles data for the purpose of quality assurance and compliance with organizational and… more
- Hospice Of San Joaquin (Stockton, CA)
- …of assigned staff, as well as ensuring the compliance of patient visit schedules, quality assurance activities, and coordination of care in the absence of the ... We are seeking a Dynamic, self-motivated Full - Time RN Team Lead who thrives in a fast-paced environment...Ensures compliance with the Hospice program plan by assuring quality service, appropriate utilization of resources, and… more
- Centene Corporation (Sacramento, CA)
- …for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. + Prepares case reviews for Medical ... benefits including a fresh perspective on workplace flexibility. + **This position requires RN California Licensure and for candidates to have a minimum of 1 year… more
- Stanford Health Care (Palo Alto, CA)
- …case management principles and practice methods, including assessment, treatment planning, utilization management, and quality assurance + Ability ... and patient care and participate in program development and quality improvement initiatives. In their role, Care Managers, by...Social Worker - State Licensure or + Nursing / RN - Registered Nurse -… more
- The County of Los Angeles (Los Angeles, CA)
- …and casting. Evaluates assessment data to define health and developmental problems. Conducts quality assurance studies of chart documents and the quality ... second largest health system in the nation, providing compassionate, quality care through its integrated system of 4 acute.... LICENSE(S) REQUIRED: A license to practice as a Registered Nurse and a certificate to practice… 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; ... experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA...LeadershipManages UM operations in accordance with National Committee on Quality Assurance (NCQA) and Health Plan requirements.Develop… more