- Prime Healthcare (Ontario, CA)
- …Post Graduate of an accredited school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a ... Employment Status Full Time Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/211752/ utilization - review - rn /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
- Fresenius Medical Center (Moreno Valley, CA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Dignity Health (San Bernardino, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** Sign-On Bonus Eligible The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… more
- HCA Healthcare (Riverside, CA)
- …a balance of optimal care and appropriate resource utilization . **Requirements:** + Registered Nurse ( RN ) with current California license required, Case ... you have the career opportunities as a Case Manager RN you want in your current role? We invest...Management Certification or utilization review preferred + Associate's Degree minimum… more
- Dignity Health (San Bernardino, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** As an RN Care Coordinator at St. Bernardine Medical Center,...+ Monitor patient progression of care, ensuring appropriate resource utilization and timely discharge. + Serve as a liaison… more
- Insight Global (Orange, CA)
- …care is being delivered Participates in the Outcomes Management and annual program review Performs utilization review of continuous care and inpatient ... Verifies/approves admitting IPOC diagnosis, treatments, staffing and supplies Monitors utilization of resources by every patient to assure cost effective… more
- ICW Group (Woodland Hills, CA)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and… more
- Prime Healthcare (Montclair, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing… more
- STG International (Corona, CA)
- …in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. ... patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …Associates degree. Three years acute hospital experience; one year experience in Utilization Review or Case Management; discharge planning and/or case ... of care. May perform other duties as assigned. Job Qualifications: [Required] Valid unrestricted California RN License. Graduate of accredited School of Nursing with… more
- Cedars-Sinai (Tarzana, CA)
- …will you be doing in this role?** The Supervisor, Clinical Operations Oncology RN is responsible for supervising the clinical staff and clinical operations of the ... policies/procedures are accurate and complete, appropriate staffing levels. Although not a staff nurse , will be expected to step into direct patient care if urgent… more
- Fresenius Medical Center (San Bernardino, CA)
- …related field preferred or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality ... barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders,… more
- Amergis (Orange, CA)
- …help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing requests for ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more