- Sharp HealthCare (San Diego, CA)
- …members to case management or quality management as appropriate for utilization or quality issues while maintaining department processes in compliance with the ... 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** **Shift… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...oversight, and/or CNA experience. At least 2 years of Utilization Management/ Case Management experience in a hospital… more
- Actalent (Sacramento, CA)
- …River City Medical Group Shift- Monday-Friday day shift Description: The Clinical Case Manager coordinates all systems/services needed for an organized, ... and cost-effective care for Managed Medi-cal patients. The Clinical Case Manager follows and manages the course...Assists Medical Director with CCS appeals. Qualifications: + CA LVN License + At least 1 year of … more
- Universal Health Services (Palmdale, CA)
- …plan with company match + SoFi Student Loan Refinancing Program Essential Job Duties: The Case Manager , a Licensed Vocational Nurse, under the Director of C ase ... and his family. This person is the expert on issues related to utilization review and discharge planning. Qualifications Requirements: + Ability to read, analyze,… more
- CVS Health (Albany, NY)
- …team will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed to ... driven timelines. Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department ...years LPN nursing experience + Unrestricted and active Compact LPN/ LVN licensure in New Jersey or New York Preferred… more
- Emanate Health (Covina, CA)
- …Excellent customer service skills required. **Minimum License Requirement:** Current California LVN License. BLS. Other certification in Case Management ... the care and services of selected patient populations. Promotes effective utilization and monitoring of health care resources. Interacts with the Emergency… more
- Universal Health Services (Riverside, CA)
- …and/or EXPERIENCE: High School Diploma or GED required. Graduate of an accredited LVN Program. AA, Diploma preferred. One to two years related experience and/or ... education and experience. CERTIFICATES, LICENSES, AND REGISTRATIONS: Current California LVN license. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties… more
- Sharp HealthCare (San Diego, CA)
- …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing ... with physicians and non-physician health care practitioners involved in case management + California Licensed Vocational Nurse ( LVN...Other Continued college education + Bachelor's Degree + Certified Case Manager (CCM) - Commission for … more
- Genesis Healthcare (Los Angeles, CA)
- POSITION SUMMARY: The Case Manager is responsible to ensure the collaborative process of assessment, planning, facilitation and advocacy for options and services ... performance improvement and communicates to s supervisor and/or Administrator.The Case Manager manages the patient case...patient plan of care subject to contract terms and case negotiations in order to minimize over- utilization … more
- Prime Healthcare (Ontario, CA)
- …of the Case Management Department under the direction of the assigned Case Manager /Social Worker in the development and implementation of the discharge plan. ... EDUCATION, EXPERIENCE, TRAINING Required qualifications: 1. Knowledge in discharge planning/ utilization management/ case management terminology and functions, in… more
- Centene Corporation (Austin, TX)
- …Associate's Degree in nursing Candidate** **Experience:** Required 2+ years of experience in utilization management and/or case management in a hospital or home ... information + Perform follow up with members engaged in case management + Facilitate provider contact as needed to...member cases with complex medical needs to Supervisor or Manager . + Act as liaison and member advocate between… more
- Sharp HealthCare (San Diego, CA)
- …Nursing & Psychiatric Technicians -REQUIRED **Preferred Qualifications** + Experience as a case manager or discharge planner interacting with managed care ... 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Other **Hours**… more
- Providence (Burbank, CA)
- …plan. The CMA also proactively escalates risks and barriers to discharge to the Case Manager ; documents all discharge planning efforts in the patient's medical ... Care **Job Schedule:** Part time **Job Shift:** **Career Track:** Nursing **Department:** 7000 UTILIZATION MGMT CA SOCAL **Address:** CA Burbank 501 S Buena Vista St… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review/MediCal Specialist will develop and maintain a full Medi-Cal ... continuum of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review/MediCal Specialist will manage the program to… more
- Tenet Healthcare (Detroit, MI)
- RN Case Manager - 2406001658 Description : The RN Case Manager is responsible to facilitate care along a continuum through effective resource ... to practice as a Registered Nurse in the State of Michigan. 4. Accredited Case Manager (ACM) preferred. 5. Must complete Tenet-s InterQual education course… more
- Prime Healthcare (National City, CA)
- …the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. ... Discharge Plan. Qualifications Minimum Requirements : 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in… more
- Elevance Health (Brazil, IN)
- …spend 4-5 days per week in-person with patients, members or providers. The ** Case Manager - LCSW/LSW/MSW** (also called the **LTSS Service Coordinator - ... Clinician)** has overall responsibility for the member's case , as required by the IN PathWays for Aging...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (Cumberland, IN)
- …4-5 days per week in-person with patients, members or providers The **RN Case Manager ** **(LTSS Service Coordinator- RN)** is responsible for overall management ... of member's case within the scope of licensure; provides supervision and...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- Tenet Healthcare (Detroit, MI)
- … Management and Compliance policies, Transition Management, and other topics specific to case management. 6. Accredited Case Manager (ACM) preferred. Skills ... Clinical Social Worker Case Management FT Days - 1406001636 Description :...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Molina Healthcare (Glen Allen, VA)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... the state of VIRGINIA. Manager will support a team of field Nurse Case Managers supporting our Medicaid program We are looking for someone with strong leadership… more