- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- WelbeHealth (Los Angeles, CA)
- …compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of ... a critical role in our participant's journey and our Utilization Management team ensures we can provide...external), clinical staff, and others to timely resolve any utilization management issues **Job Requirements:** + Minimum… more
- Emanate Health (Covina, CA)
- …Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred. ... States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- Emanate Health (Covina, CA)
- …**Minimum Experience Requirement :** Minimum ten (10) years of combined experience in utilization management , revenue cycle, or charge integrity; at least two ... country. **J** **ob Summary** The Director of Revenue Integrity & Clinical Utilization Review provides clinical oversight and operational leadership for clinical … more
- Select Medical (Los Angeles, CA)
- …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... in Social Work required or Current state licensure as a Registered Nurse required. + Previous experience in Case Management and Discharge Planning preferred.… more
- UCLA Health (Los Angeles, CA)
- …delivery for + Ensure seamless integration of various clinical functions including Utilization Management , Population Health, Case and Care Management , ... - $331,800/annually Qualifications We're seeking an experienced leader with: + A Registered Nurse License, Advanced Practice Provider ( Nurse Practitioner… more
- Fresenius Medical Center (Bellflower, 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 ... FT RN role in our outpatient surgery center The...adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other… more
- LA Care Health Plan (Los Angeles, CA)
- …of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Payment Integrity Nurse Coder RN III Job Category:...process through medical record review for Payment Integrity and Utilization Management projects. The position serves as… more
- The County of Los Angeles (Los Angeles, CA)
- …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used… more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Los Angeles, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Los Angeles, CA)
- …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...experience* at the level of Los Angeles County classification Registered Nurse I**. -AND- 2. A license… more
- Select Medical (Los Angeles, CA)
- …/ Los Angeles, CA Case Manager (CM) - Full Time (on-site) - 8 hr shifts Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Schedule: Mon - ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
- Molina Healthcare (Los Angeles, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... with California providers **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current… more
- Molina Healthcare (Los Angeles, CA)
- …Previous experience in Hospital Acute Care, ER or ICU, Inpatient/ Concurrent Review, Utilization Review / Utilization Management and knowledge of InterQual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Cedars-Sinai (Los Angeles, CA)
- …thereafter as a condition of continued employment. **Req ID** : 8846 **Working Title** : Registered Nurse III - Cancer Center Exams - 8 Hour Days **Department** ... honest, encouraging, supportive and conscientious manner. As a Clinical Nurse III, you will deliver direct care to assigned...competently provide care to patients + Utilizes effective time management to complete all assignments in a timely manner… more
- UCLA Health (Los Angeles, CA)
- …+ 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
- Molina Healthcare (Long Beach, CA)
- **HOSPICE OVERSIGHT CASE MANAGER ( REGISTERED NURSE )** California residents preferred** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works ... Exceptional knowledge of California hospice facilities Working knowledge of Utilization Management processes **Preferred License, Certification, Association**… more