- Blue Shield of California (Long Beach, CA)
- …health care or related field. 3+ years managed care experience preferred. Certified Case Manager (CCM) Certification or is in process of completing certification ... and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of...community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/163839/ rn - case - manager utilization ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... of an accredited nursing program Bachelor's Degree Nursing **Licenses:** RN State License Basic Life Support (BLS) **Experience:** 3...**Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR… more
- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case ...Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training Physical Requirements… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Utilization Management RN Job Category: Clinical...California License Certified Case Manager (CCM) Licenses/Certifications Preferred Required Training… 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 ... Utilization Management Nurse Specialist RN...California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements… more
- Providence (Santa Monica, CA)
- …obtaining the degree will not be a condition of employment. + Upon hire: California Registered Nurse License + 2 years of experience in Healthcare related field ... Degree in Nursing or Healthcare related field. + A RN with 20 years of RN experience...Ambulatory, Post-Acute, etc.) + 2 years of experience in Case Management (Care Coordination or Utilization Management)… more
- Providence (Tarzana, CA)
- …obtaining the degree will not be a condition of employment. + Upon hire: California Registered Nurse License + California Fire and Life Safety Card - National ... to provide timely clinical reviews to payers. The Care Manager utilizes the following processes to meet the patient's...(Acute, Ambulatory, Post-Acute, etc.) + 2 years Experience in Case Management (Care Coordination or Utilization Management)… more
- Cedars-Sinai (Marina Del Rey, CA)
- …+ Current CA Registered Nurse Licensure, Required + Certified Case Manager CCM or ACM, Preferred **Experience** : + Minimum of two ... with the highest quality healthcare! **Position Summary:** As an RN Case Manager (ED Services),...Responsibilities:** + Participates in a multi-disciplinary care team + Utilization review. + Reviews care and treatment for appropriateness… more
- Pipeline Health System, LLC (Gardena, CA)
- …hospitals to available beds in our hospitals for quality care. Job Description & Requirements The RN Case Manager (CM) performs a wide variety of tasks and ... team to ensure coordination of patient care and wise utilization of resources. + Documents case management...Nursing + Current BLS for Health Care Provider card. + Accredited Case Manager (ACM) or Certified… more
- Providence (Santa Monica, CA)
- …Qualifications:** + Graduate of an accredited school of nursing. + upon hire: California Registered Nurse License. + 3 years Clinical experience in an HMO, ... Transplant, or Wound Care. + 3 years experience in utilization management or case management. **Why Join Providence?** Our best-in-class benefits are uniquely… more
- Actalent (Los Angeles, CA)
- Largest national Medicaid Managed Care Organization is looking for a REMOTE RN Case Manager to join their growing team! Opportunity to make an impact with an ... industry leader in a fast-paced environment! Requirements: + CA RN license + Case Management experience +...outcome * Assess the member's current health status, resource utilization , past and present treatment plan and services, prognosis,… more
- Amergis (Los Angeles, CA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... assessments and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart review/audits monthly… more
- UCLA Health (Santa Monica, CA)
- …+ BSN or MSN + CA RN License and BLS + Recent experience in case management, utilization management and discharge planning + Minimum of three years of acute ... 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
- UCLA Health (Los Angeles, CA)
- …staff) + 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
- UCLA Health (West Hills, CA)
- …MSN + CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years of ... 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
- Emanate Health (West Covina, CA)
- …nurses new to the US healthcare system must satisfactorily complete the Emanate Health RN Residency Program within the first 6 months of employment. Two years recent ... acute clinical experience. Experience with discharge planning, utilization management and critical pathways preferred. Effective written, verbal and time management… more
- UCLA Health (Los Angeles, CA)
- …in the care of the patient and decreasing fragmentation and duplication of care, the Nurse Case Manager /Clinical Advisor is able to enhance the quality and ... Description Under the direction of the RN Asst. Director for Utilization Review, Intensive Case Management, you will support and perform duties to provide… more
- UCLA Health (Los Angeles, CA)
- …regulations + Ability to travel/attend off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,… more
- Molina Healthcare (Long Beach, CA)
- **For this position we are seeking a REGISTERED NURSE Program Manager to work with our CLINICAL SERVICES TRAINING TEAM to support our training programs.** ... training materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse + Bachelor's or master's degree in Nursing.… more
