- Providence (Mission Hills, CA)
- **Description** RN - Utilization Review ...+ Associate's Degree in Nursing. + Upon hire: California Registered Nurse License + 2 years of ... is Remote (Working from Home 100%) and will work Part -Time, 8-hour Day shifts (20 hours per week). Successful... Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently… 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: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- 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 ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices.… 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 - ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- Guidehouse (Los Angeles, CA)
- …**Clearance Required** **:** None **What You Will Do** **:** The **Hospital Admitting Registered Nurse PART ** **TIME, varied shiftts** will facilitate ... of prior relevant experience, 2 of the years as RN + Graduation from an accredited school of nursing....Nice To Have** **:** + Two years' experience in utilization review with external payors within a… more
- Emanate Health (Covina, CA)
- …of California, and hospital policies, goals, and objectives. Completes Utilization Review of Behavioral Health Services. Charge Nurse will have expert ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...ranked company in the country. **Job Summary** The Charge Nurse is responsible for supervising staff and the operation… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... most prone to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions + Administers, either… more
- Elevance Health (Los Angeles, CA)
- **Be Part of an Extraordinary Team** _A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, ... an expanding set of clinical domains, including radiology, cardiology and oncology._ ** Nurse Reviewer I** **Location:** This is a virtual position open to Pacific,… more
- Elevance Health (Los Angeles, CA)
- …**Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management (BH CM) or ... and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate… more
- Elevance Health (Los Angeles, CA)
- …and outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses appropriate screening ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- Elevance Health (Los Angeles, CA)
- **Telephonic Nurse Case Manager I** **Location: Virtual:** **This role enables associates to work virtually full-time, with the exception of required in-person ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager I** is responsible for performing care management within the… more